HERSCHEL II PROGRAM SUBMITTAL FORM

Date:           ___________________________________

To:             The Herschel II Certification Committee
                Rose City Astronomers
                Oregon Museum of Science and Industry
                1945 SE Water Avenue
                Portland, OR   97214

The attached Herschel II program materials are submitted for certification.  
PLEASE PRINT LEGIBLY!


NAME:           _________________________________________________________________
                (Please PRINT your name the way you want the certificate to read.)

ADDRESS:        _________________________________________________________________

                _________________________________________________________________

E-mail:         _________________________________Telephone: (     )______________

Astronomical League Club Affiliation:____________________________________________

Search Method:  _____ Device-Aided
                _____ 100% Manual

Enclosed are:   _____ Index to Observations
                _____ Observation Notes on 400 Objects

You have the option of having the certificate and pin returned to the Awards Chairman 
or Alcor in your astronomy club for presentation at a public meeting.  Please indicate 
below the name and address of the individual to whom these materials should be returned.  
Indicate "Self" if it is the above submittal's name and address.  If these materials 
are returned to anyone other than "Self," a postcard indicating the date returned 
will also be sent to you for your information.

NAME:           ________________________________________________________________

ADDRESS:        ________________________________________________________________

                ________________________________________________________________

                ________________________________________________________________

                
                ____  Check here if you want your description copies returned.  



Reminder:  Observers should keep copies of all observations in case they are 
           lost in the mail.

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