2013 Registration

Name*

Organization Name*

Space Grant Affiliation (If applicable)

Mailing Address*

Phone Number*

Fax Number*

Email*

T-Shirt Size*

Have read the Week of Launch Schedule for RockSat 2013 Wallops integration? (Link at top of page)*

Yes

No

Have you reviewed the Thursday, June 13, 2013 RockSat Check Out/In Procedure? (Link at top of page)*

Yes

No

When do you plan to arrive at Chincoteague Island?*

Do you agree that you WILL be at the Refuge Inn at for Check Out/In Procedure (Link at top of page) at you assigned time on Thursday, June 13, 2013 in order to participate in the Friday activities at Wallops?*

Yes

No

Do you acknowledge that the RockSat launch on a Terrier-Orion 2 stage sounding rocket out of NASA's Wallops Flight Facility is weather dependant?*

Yes

No

Do you acknowledge that the RockSat launch could be on Friday, June 21st, 2013?*

Yes

No

Have you made your hotel reservations and if so where?*

Is your school planning on sending more than 4 participants to the RockSat activities?*

Are you a student, faculty, professional?*

Any Special Requests/Needs:

Static Content

If you have any questions about registration, please contact me directly before submitting your registration. I, Chris Koehler, can be reached at 303-492-4750 or by email at koehler@colorado.edu

Before submitting your registration, check the box if you agree to the fine print listed above.*

I agree with the conditions listed above and certify that I am a US Person.

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