MARCH
23-27,2003 225th ACS National Meeting Advance Registration Form 3 WAYS TO REGISTER: Regi
' February 26 and receive registi I BY FAX: Fax the completed registration form by February 26 to 480-443-8767 (Credit card payments only) I BY MAIL: Mail completed registration form by February 26 to ACS Registration, c/o Matrix Registration 6501 E. Greenway Parkway, Ste. 102, PMB 497, Scottsdale, AZ 85260 (Check & credit card payments)
I VIA THE WEB: Go to www.chemistry.org/meetings/neworleans2003 and select "registration." NEW: Avoid long lines on-site. Register online with your credit card up until March 7. Higher rates prevail after February 26. (Credit card payments only) I CUSTOMER SERVICE INQUIRIES: Phone 1-800-650-2512 •
Dr. •
Mr. •
Ms. •
Ml_
Mrs. First Name _
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Nickname if other than first name Address #1
Advance Registration Savings End February 26
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City
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Phone Address #2 (If applicable) Street Address
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NEW ORLEANS, LA
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^FHT*
Check here if you would like to receive pre/post-show mailings from this National Meeting's exhibiting companies.
Guest Registration (Fee: $30)
Attendees are allowed to bring a guest, usually a family member or friend, who is not in the field of chemistry. Guest entrance badges will be sent to the attendee's address. Please print guest name here: Professional Discipline (Check one) • Academia • Government • Industry • Highest Degree Received • • Other (Please specify)
B.S. •
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FEES: Advance Registration ACS Member Fees
Other
Member No. Required • Member - $275 • National Affiliate - $275 • Emeritus-$140 • Retired-$140 • 50-Year Member - (No Fee) • Unemployed Member - (No Fee) • Pre-College Teacher - $45 • Graduate Student - $65 • Undergraduate Student - $45 • One-Day Registration - $140 • Sunday • Monday • Tuesday • Wednesday • Thursday
Ph.D.
Professional Concentration (Check all that apply) • • Q • • • • • • • • Q • • • • • •
Aerospace/Transportation Agriculture & Food Analytical Biochemistry Biotechnology Chemical Education Chemical Information Clinical/Diagnostic Colloids & Surfaces Combinatorial Chemistry Computing/Molecular Modeling Electronics/Semiconductors Energy/Fuels Environmental Forensics Geochemistry Glass/Ceramics/Composites Health & Safety
• • • • • • • • • • • • • • • • • •
Inorganic Law/Legal Affairs Lubricants/Oils Marketing/Sales/Business Materials Metals/Metal Products Nuclear Organic Paint/Coatings Personal Care/Cosmetics Pharmaceutical/Medicinal Physical Polymers/Plastics Pulp/Paper/Wood Rubber Soaps/Detergents/Cleaners Textiles/Fiber Toxicology OTHER
Non ACS Member Fees •
• Product Interests (Check all that apply) • • • • • •
Analytical Services Chemicals Computers/Hardware Computers/Software Database Services Glassware
• • • • • •
Instruments/Chromatography Instruments/Spectroscopy Lab Equipment Lab Supplies Publications R&D/Testing Services
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Check here if this is your first ACS National Meeting.
•
Please check here if you require special accessibility accom modations. Please attach a description of your needs.
Address during meeting α Hotel (name) • Other Paid by: • •
Check - made payable (in U.S. dollars only) to ACS. •
Nonmember: Chemical Scientist - $485 Q Visitor: Non-Chemical Scientist - $275 • Visitor: Chemical Technician -$275 • Precollege Teacher - $45 • Graduate Student - $275 • Undergraduate Student - $140 • One-Day Registration - $275 • Sunday • Monday • Tuesday • Wednesday • Thursday •
Guest of Registrant - $30
Exposition Only Visitors • Adult - $35 • Student-$10
FEES: Social Events Only Event No. No. Tickets $ Per Ticket
$
TOTAL
$
© FEES: Abstracts Book
CD-ROM
Non ACS Member $150_
_Set(s) $75
ea
ACS Member
_Set(s) $50
ea
$100_
θ $ Please check one • I will pick up my abstract book/CD-ROM at the National Meeting • Please mail the abstract book/CD-ROM to the address I selected below (US ONLY, NO P.O. Boxes). Postage is $15.00 for each book/$8.00 for each CD-ROM Λ
©$ TOTAL OF 1 - 4 $ Registration Procedures US and Canadian attendees who register by February 26 will receive entrance badges and tickets in the mail approximately 2 weeks before the meeting. After February 26, ACS will not accept faxed or mailed registration forms. Starting February 27, attendees paying by credit card can avoid long lines on-site by registering online at www.chemistry.org/ meetings/neworleans2003 and picking up their badge in the pre-registered line at the Ernest N. Morial Convention Center. Higher prices go into effect February 26 at 8:00 pm. All international attendees will pick up their badges in the pre-registration area at the Ernest N. Morial Convention Center.
©$ Mailing Instructions (Please check)
Mail to Address #1
Mail to Address #2
Entrance badge and abstract book/CD-ROM (if applicable) Exhibitor promotional materials (if applicable) American Express
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JANUARY
27,
2003
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