Workshop Registration Form
Molecular Visualization in Biological Science Education
University of Massachusetts, Amherst

For information needed to fill out this form, visit
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to print this form, fill out, then
    FAX to 413-545-2532
or snail mail to:
    Eric Martz
    Department of Microbiology
    University of Massachusetts
    Amherst MA 01003-5720

Location of workshop: AMHERST, MASSACHUSETTS

Three meeting dates of workshop (You must come on all three dates!):

Date for first meeting:

Date for second meeting:

Date for third meeting:





Email address:

Snail mail address at your college or university:

Voice phone number:

FAX phone number:

Classes you teach (include subject, credit hours, level of students,
and typical enrollment):

Familiarity with the web: expert, moderate, slight, none?

Familiarity with RasMol: expert, moderate, slight, none?

Participants will work on their preferred computer type when
possible.  Preferred computer: Windows, Macintosh?

Estimated travel time or mileage to workshop site:

If your travel exceeds 2 hr/80 mi (Boston residents are eligible), would
you like free accomodations for the night prior to each workshop?

If your travel exceeds 6 hr/250 mi, would you like free accomodations
for the night after each workshop?

If you have requested accomodations, please say whether you are male
or female (for matching roommates).

Accomodations are limited by budget and will be allocated to the
earliest registrants.  Accomodations will normally be non-smoking.
Would you prefer smoking accomodations?

Do you require a wheelchair, or have other special needs?

Confirmation of your registration and further instructions will be sent
to the email address you have given above.