TEST FORM PAGE - OSIRIS-REx Mission

NAME*

First Last

YOUR EMAIL*

MINOR PLANET CENTER CODE

TELESCOPE PROGRAM CODES (IF ANY)*

LOCATION & INSTRUMENTATION:

LATITUDE (N OR S; TO NEAREST 0.1 SECOND)

LONGITUDE (E OR W; TO NEAREST 0.1 SECOND)

APERTURE

TYPE OF TELESCOPE (REFLECTOR, SCHMIDT-CASSEGRAIN, ETC.)

TYPE OR BRAND/MODEL OF CCD

FILTER(S) AVAILABLE

ADDITIONAL TELESCOPE

ASTRONOMICAL LEAGUE OBSERVER INFORMATION:

(FOR TARGET NEOS!)

NAME OF MEMBER ASTRONOMY CLUB

MEMBER AT LARGE

Yes
No

ADDITIONAL INFORMATION:

Please take a few moments to answer the following questions. Your answers help us understand our participants to improve our programs.

I AM A/AN

Educator
Student
General Public
Amateur or Professional Astronomer

GENDER

Female
Male

Age

STATE/PROVINCE*

COUNTRY*

I LIVE IN

Urban <250,000
Urban 250,000-500,000
Over 500,000
Rural

I LEARNED ABOUT TARGET ASTEROIDS! THROUGH

AGREEMENT:

By submitting this registration:

- I understand that the images and observational data submitted will be used for scientific research.
- I may submit or use these data in other projects.
- I may receive occasional communications related to Target Asteroids!, Target NEOs! or the OSIRIS-REx asteroid sample return mission.
- My name may appear on the OSIRIS-REx website, publications, or "wall of fame-type" acknowledgements as a Target Asteroids! observer.

Agreement Acknowledgement

Yes, I agree to the above terms

LOCATION & INSTRUMENTATION:

ASTRONOMICAL LEAGUE OBSERVER INFORMATION:

ADDITIONAL INFORMATION:

AGREEMENT:

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