Go to Nanoparticles.org Home Page Particles 2011 Short Course 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

Select Course or Courses (click to activate checkbox; all fees in US dollars):
 
Course 1 - $725 Surface Modification Chemistries for Particles and Interfaces - Friday, 8 July 2011
Course 2 - $725 CANCELLED Synthesis, Processing and Properties of Metal Oxide Nanopowders - Saturday, 9 July 2011
 
Select Any Applicable Discounts [and subtract discount(s) from base course fee(s)]:

  Registered for Particles 2011 Conference - $100 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):


Check if you would like on-site reservations at the Holiday Inn Berlin City-West at the group rate of EUR 89 per night (single occupancy) or at the double occupancy rate of EUR 107 per night (each rate includes VAT and service charges and also includes full buffet breakast) and guarantee your reservation with your credit card. The number of rooms available at this highly favored conference rate is limited and will be filled on a first-come, first-served basis with conferees who have registered for the conference. 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) (US$130 x Number of nights) in US$ 

Payment by check must include full hotel prepayment if hotel reservation is selected. Credit card payment of registration and guarantee of hotel amount will be processed upon receipt; credit card payment of hotel amount will be processed on departure date selected.

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 short course.
Short course registration fees are refundable, less a 20% service charge, if cancellation is made earlier than 12 April 2011. After this date refunds, less a 20% service charge, will be made only if the space is replaced by another short course student. Cancellations must be made or requested in writing by fax, and after 12 April 2011 such requests will be honored in order of receipt, if the space can be filled with another short course student.

Hotel deposits or guarantees are fully refundable if cancelled prior to 12 April 2011. After this date and through 7 May 2011, hotel deposits or guarantees will be refunded only if the room is occupied by another conferee. After 7 May 2011, 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
______________________________________

After 4 Jul, through 9 Jul, please send completed registration form ELECTRONICALLY ONLY
to Melanie at:
17melanie@gmail.com

Please fill out (type before printing), print, sign, and scan this form, and send electronically to Melanie via e-mail at 17melanie@gmail.com.

For Short Course/Workshop Registration Click HERE

© 2011 Particles Conference