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REGISTRATION
FORM
28-29
April, 2006
University
of
Texas
at Austin
| Complete this form and
return it no later than April 1st, 200
Click for a PDF copy of this form. |
Dr.
Bobby L. Barnett
Department of Chemistry
University of Cincinnati
PO Box 210172
Cincinnati, OH 45221-0172
bobby.barnett@uc.edu
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Registration
Information:
| First and Last Name (for badge) |
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| Affiliation (for badge) |
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| Mailing
Address: |
|
| Phone:
E-mail:
|
Fax:
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Conference
Registration Fee: $15.00
(includes opening reception and refreshment breaks)
Note:
UT students and postdocs can attend the Saturday Conference
for no fee, but must register. |
Number Attending ______ |
| Banquet:
$60.00 |
Number Attending ______ |
PAYMENT:
Check or money order made payable to: University
of Cinncinati - Davis Symposium
Please
list any special needs:
Further
information on the program and local arrangements can be found on our
web site at:
http://bioinst.cm.utexas.edu/davis_sympos
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