Pre-registration Form      

Wednesday, October 29, 2008 at  the Burton Manor
27777 Schoolcraft, Livonia, MI, 734-427-6058 (See map)

Fill out form and and use submit button to pre-register for the Symposium. PAY AT THE DOOR.. The fee includes all programs including workshop(s), coffee breaks, instrument exhibit, luncheon, and poster/mixer reception. Programs, badges, etc., can be picked up on arrival. Registration will open at 7:30am. The first sessions will begin at 8:30am. Anachem membership is not necessary to attend.the Symposium, but you must be registered. Deadline tcancel  registration is October 21st.  Registration must be received by October27th.  It will be necessary to bill no shows. We cannot accept credit cards. Contact Ed Havlena at 313-393-3685 for more info.
                            Don't forget to check for late changes in the program.

Name

Address

Address2

City, State, Zip

        

Hphone, Wphone

      

Email

Pre-registration Fees

Regular registration

 @ $60ea=

Student/Retiree

 @ $20ea=

2009  Anachem Dues

Regular dues

 @ $25ea

 Student/Retiree

 @$10ea

    Make checks out to Anachem    
Pay at the door---Total due= 

    I will attend the Advances in Macromolecular Characterization by GPC/SEC Workshop
     I will attend the Materials Characterization using Thermal Analysis workshop

 Area of Work

Area of Specialization

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