Registration Form
FACSS XXI October 2-7,1994
First Name
Middle Initial
Last Name
Work Phone
Fax Phone
Spouse's Name (for name badge if attending)
State
Zip/Postal Code
Company
Address
City
Country
For information purposes only, please let us know which hotel you have chosen:
Registration Fees
"Memberships
Preregistration: Deadline Date September 3,1994 Nonmember 160.00 $ "Member 135.00 $ On-Site Registration Nonmember 200.00 $ 'Member 175.00 $ Student 35.00 $ Exhibits Only 25.00 $ Single Day 100.00 $ Friday Only 50.00 $ Subtotal Registration Fees $
For member rate, please mark appropriate boxes
Workshop Fees A. B. C. D. E. F.
Funding Research Sampling & Concentration Microwave Sample Prep Near-IR SFE&SFC Env. Lab Quality
25.00 90.00 60.00 60.00 90.00 60.00
$ $ $ $ $ $
G. Art of Samp Prep H. Analytical Chemists in Industry I. FIA J. Fluorescence Spectroscopy K. Statistics & Chemometrics L. ICPMS M. Networks & LIMS "Subtotal Workshop Fees
60.00 Free 60.00 60.00 90.00 60.00 60.00
S S $ $ $ $ $ $
D
1. ACS Division of Analytical Chemistry
D
2. SAS
D
3. Anachem
D
4. ISA
D
5. Coblentz Society
Π
6. Royal Society of Chemistry
Technical Interests D
1.NMR
D
2. Molecular Spectroscopy
D
3. Atomic Spectroscopy
D
4. Mass Spectrometry
D
5. Spectroscopy, Other
D
6. Chromatography
Π
7. Process/Control
D
8. Electrochemistry
D
9. Clinical
Advertising Where did you learn of FACSS? D 1. Spectroscopy D 2. Applied Spectroscopy D 3. American Laboratory D 4. The bulletin Spectroscopy Ο 5. Analytical Chemistry D 6. FACSS Direct Mailer Π 7. Other
Special Events Fees Wednesday Night Gala @40.00 $ See the Special Events Desk for additional event information. Subtotal Special Events Fees
Mail to: FACSS 198 Thomas Johnson Dr., Suite S-2 Frederick, MD 21702
$
Payment Information Registration Total $ Workshop Total $ Special Event Total $ Grand Total $ Cash ck#___ VI/MC#_ Signature.
. Firm ck D
Personal ck D Exp. date
Analytical Chemistry, Vol. 66, No. 17, September
1, 1994 8 7 5 A
