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LIPTA 2019 Physics Olympics Conference Registration & Payment via Check

Please fill out the form below and submit it - this will email your registration information to the LIPTA executive commitee. On the next page is the address where you should mail your check.

 

  Advisor Name:

School:

  School Phone: 

Advisor Home Phone: 

Advisor Cell Phone: 

Advisor Email: 

  

ALL fields are required - Phone numbers will ONLY be used in case of weather emergency

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