Registration Form for Short Courses Preceding
Particles 2004
4-6 March 2004, 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.  (Check all that apply.)

 
Name  Telephone
Title Fax

 
Organization

 
Address E-Mail
Address

 
City/Town State/Province

 
Zip/PostalCode Country

Select Course or Courses (click to activate checkbox; all fees in US dollars):
 
Course 1 - $650 Nanoparticle Synthesis- Thursday, March 4, 2004
Course 2 - $650 Precision Control of Crystallization Processes - Friday, March 5, 2004
Course 3 - $650 Particle Characterization - Friday, March 5, 2004
Course 4 - $650 Synthesis, Processing and Properties of Metal Oxide Nanopowders - Saturday, March 6, 2004
Course 5 - $650 Size-Reduction Dispersion Technology - Saturday, March 6, 2004
Course 6 - $650 Cancelled Particle-Based Materials Synthesis - Saturday, March 6, 2004

 
Select Any Applicable Discounts [and subtract discount(s) from base course fee(s)]:

  Registered for Particles 2004 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; in US dollars):


 
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.).
Do not use this option after 20 February 2004.

 
Visa Master Card American Express

 
Card No. Exp. Date
Name on Card Signature
______________________________________

Please fax completed registration form to: (585) 482-7795 (No cover sheet required)

 

 Or mail to:  Particles Conference
                       265 Clover Street
                       Rochester, NY 14610-2246,     U.S.A.
Questions? 
Call (585) 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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.2004 Particles Conference