Registration Form for Short Courses Preceding
Particles 2002
20-23 April 2002, Orlando, Florida
Howard Johnson Plaza Hotel
[adjacent (short walking distance) to the Rosen Centre Hotel]
9956 Hawaiian Court, Orlando, Florida 32819
407-351-5100     800-826-4847

Please fill out (type before printing), print, sign this form, and submit via fax or mail.

Mr. Ms.Dr.Prof.  
Name  Telephone
Title Fax
Organization
Address E-Mail
Address
City/Town State/Province
Zip/PostalCode Country

Select Course or Courses (click to activate checkbox):
 
Course 1 - $625 Nanoparticle Synthesis - Thursday, April 18, 2002
Course 2 - $625 CANCELLED -Surfactants and Block Copolymers - Thursday, April 18, 2002
Course 3 - $625 Particle-Based Materials Synthesis - Friday, April 19, 2002
Course 4 - $625 Introduction to Particle Surface Modification - Friday, April 19, 2002
Course 5 - $625 Size-Reduction Dispersion Technology - Saturday, April 20, 2002
Course 6 - $625 Precision Control of Crystallization Processes - Saturday, April 20, 2002
Select Any Applicable Discounts [and subtract discount(s) from base course fee(s)]:

  Registered for Particles 2002 Conference - $50 discount per course
  Taking multiple courses: - $50 discount per course
  Group of two or more from same organization taking same courses - $50 discount per course (describe group:  )


Enter Total Course Fee (base fee minus discounts):

For groups of 5 or more, call for additional discount.
 
Method of Payment:
(All payments must be in U.S. dollars)
Cancellations & Refunds
Check Enclosed 
Checks must be drawn upon a U.S. bank.  Make checks payable to:  Particles Conference
                    (EIN 16-1565388)
Registration fees are refundable, less a 15% service charge, if cancellation is made earlier than 14 days before the couese date. No refunds will be given after that date. All cancellations must be confirmed in writing. Substitutions from the same organization may be made at any time without penalty.
Payment by wire transfer  Wire payments to Manufacturers and Traders Trust Company (44 Exchange Boulevard, Rochester, NY 14612, USA), ABA Routing No. xxxx, Particles Conference Account No. xxxx; transfer fees not included in wire payment are due upon registration on site (contact conference office for Routing and Account Nos.).
Visa Master Card American Express
Card No. Exp. Date
Name on Card Signature
______________________________________

Please fax completed registration form to: (716) 482-7795 (No cover sheet required)
 Or mail to:  Particles Conference
                     265 Clover Street
                     Rochester, NY   14610-2246, U.S.A.
Questions?
Call (716) 288-5913
E-mail:  info@nanoparticles.org

Please fill out (type before printing), print, sign this form, and submit via fax or mail.
 
 


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(C) 2002 Particles Conference