nanoparticles.org - Particles 2005 Registration Form

Particles 2005 Conference and Hotel Registration
Please fill out (type before printing), print, sign this form,
and submit via fax or mail (see bottom of this page).

Mr. Ms. Dr. Prof. (Check all that apply.)

Name				Telephone
Title				Fax

Organization

Address		E-Mail
Address

City/Town

State/Province

Zip/PostalCode

Country

Registration Fee or Fees in US$ Due:

Meeting Registration

Accompanying Person

Advance Registration - Through 9 August 2005
Industrial Attendee
       Through 9 August - US$1075
Academic and Government Laboratory Attendee
       Through 9 August - US$775
Accompanying Person:
       Through 9 August - US$350

AFTER 9 August 2005 ONLY ON-SITE REGISTRATION AVAILABLE
       All Attendees - US$1275
       Accompanying Person - US$350

Accompanying person's name:
No more rooms available!
Saturday night, August 13th, is sold out; no more rooms are available for this night. Check if you would like on-site reservations at the Sir Francis Drake Hotel. Our group block at the group rate of US$139 plus tax (currently 14%) for a total of US$158.46 per night (single and double occupancy) is full, although some nights are still available at this rate, and others are more expensive. We will check on prices available for the nights of your stay and get back to you. If acceptable, you may guarantee your reservation with your credit card. See transferability, cancellation and refund policy below.

Arrival Date Number of Nights Departure Date

If you are sharing a room, please enter other person's name:

Hotel Guarantee (credit card) or Prepayment (check or wire) (US$158.46 x Number of nights) in US$

Method of Payment (All payments must be in U.S. dollars): Registration Transferability, Cancellations & Refunds

Check Enclosed
Checks must be drawn upon a U.S. bank. Make checks payable to: Particles Conference
(EIN 16-1565388) Registrations are transferable and substitutions from the same organization may be made without penalty prior to and through arrival at the conference.
Conference registration fees are refundable, less a 15% service charge, if cancellation is made earlier than 13 July 2005. After this date refunds, less a 15% service charge, will be made only if the space is replaced by another conferee. Cancellations must be made or requested in writing by fax, and after 13 July 2005 such requests will be honored in order of receipt, if the space can be filled with another conferee.
Hotel deposits or guarantees are fully refundable if cancelled prior to 13 July 2005. After this date and through 9 August 2005, hotel deposits or guarantees will be refunded only if the room is occupied by another conferee. After 9 August 2005, hotel deposits or guarantees will be refunded only if the room is occupied by another guest.

Visa MasterCard American Express Discover Diners Club Japanese Credit Bureau

Card No. Exp. Date

Name on Card Signature
______________________________________

Card No.			Exp. Date
Name on Card			Signature	______________________________________

Please fax completed registration form to: 1-585-482-7795 (No cover sheet required)

Or mail to: Particles 2005
265 Clover Street
Rochester, NY 14610-2246, USA Questions?
Call 1-585-288-5913
E-mail: info@nanoparticles.org

Please fill out (type before printing), print, sign this form, and submit via fax or mail.
For Short Course/Workshop Registration Click HERE
© 2005 Particles Conference