Nineteenth International Twin Workshop Registration

March 6 - March 10, 2006
Institute for Behavioral Genetics
University of Colorado
Boulder, Colorado
Please print clearly
Name:

Affiliation:

Address:



Telephone:

Fax:
E-Mail:

Research Interests:






The following information has been requested by the funding agency, but a response is optional.

Gender: Male
Female
Do you consider yourself to be Spanish/Hispanic/Latino? Yes
No
Which racial category best describes you?
Asian


Native Hawaiian or Other Pacific Islander


Black or African American


White


More than one race


Unknown



Fee
Due Date
Registration Fee:
$350
January 14, 2005

$400
January 15, 2005 or later
The registration fee must be payable in US funds on a US bank.
The registration fee is fully refundable until February 1, 2005, but is not refundable after February 1, 2005.
Please make registration check payable to "University of Colorado"
Mail to:
Kendra Locher
Institute for Behavioral Genetics
University of Colorado
447 UCB
Boulder, Colorado 80309-0447