Confronting QCD With Experiment:  Puzzles and Challenges
7-9 November 1996
Fermi National Accelerator Laboratory


Registration Form

Deadline: October 15, 1996


Name (Last, First, Initial):

Institution:

Mailing Address:


City, State, ZIP Code, Country:

E-mail address:

Telephone:


Payment options for $75* registration fee:

	_____ 1) Budget code: _______

	_____ 2) Check made out to "Fermilab"

	_____ 3) Pay at symposium

*The $75 fee also includes dinner and a copy of all transparencies.

Will attend dinner on Friday, November 8:

	_____ Yes	_____ No	

Dinner location yet to be determined.


Please send form/check to Olivia Vizcarra by one of the following:

	E-mail:	OLIVIA@FNAL.GOV

	Mail:	Fermilab
                P.O 500, MS 220
                Batavia, IL 60510

	Fax:	+1(630)840-2950