Advance registration—192nd ACS National Meeting Anaheim, Calif.
Sept. 7-12, 1986
Deadline for receipt of registration: Aug. 15 Deadline for requests for full refunds: Aug. 29 Deadline for requests for partial refunds: Sept. 30
Mail this form with p a y m e n t to: American Chemical Society, Meetings, P.O.Box 18598 20th Street Station Washington, D.C. 20036-9998
M a k e c h e c k p a y a b l e to: A C S or A m e r i c a n C h e m i c a l Society Please submit a s e p a r a t e form for e a c h registrant. D Dr.
D Mr.
D Ms
Π Miss
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Surname
M.I.
First or Nickname
Name for badge Affiliation Affiliation address City, State ZIP, Country Telephone (office, home)
Days at meeting: D
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Type of affiliation:
D Academia
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Please check here if you need special services for the handicapped. We will contact you prior to the meeting.
Address during meeting Which division's program influenced you to attend: m o s t .
_ next.
FEES: Registration—check one only 1 2 3 4 5 6 7 8 9
D D D D D D D D D
Member (a, $90 National affiliate (& $90 Nonmember: U.S. resident chemical scientist @ $165 Member emeritus (a $35 Visitor: non-U.S. resident or nonchemical scientist or chemical technician (a $90 Visitor: family of registrant (a $15 Student: less than postdoctoral status, member or nonmember (a $15 One day (« $60 | - D Mo 3 D Tu 4 D We 5 D Th 6 D Fr One day student (a $5.00
FEES: Event tickets Event No. No. tickets
Registration fee $_ (r/
Total
Ticket total $_ FEES: Abstracts Sets at $34—nonmember Sets at $26—member .division Sets at $24—member o f _ D Will pick up at meeting Π Enclosed is $3.00 for each book mailed (U.S. only). Provide street address
Paid by:
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Signature:. Mailing address for registration materials and abstracts. (Note: Registration materials can be mailed to U.S. and Canadian residents only. Abstracts can be mailed to U.S. residents only.) D Same as above D Send to: Street City, State, ZIP 62
June 23, 1986 C&EN
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