Registration Form
Name: (Circle:        Prof.             Dr.               Mr.           Ms.)


Registration Fee: $50 (US)

Method of Payment (circle: check credit card)

Checks: Please make checks payable to: "Geophysics in Rock Engineering
Credit Cards : circle

                       VISA                         Mastercard                      Discover Card

Credit Card Number:

Expiration Date (four digits):


The Registration Form should be sent to the address below by FAX or mail, or, you can send an e-mail containing the information listed above. Return Form to:

Prof. Laura J. Pyrak-Nolte,
Chair of 2nd International Workshop Geophysics in Rock Engineering, 
Purdue University,  Department of Physics, 1396 Physics Building, 
West Lafayette, Indiana 47907-1396 USA

Fax: 765 - 494 - 0706   Telephone: 765 - 494 - 3027      e-mail: