Career Celebration  /  Symposium on Crystal Engineering

April 28-29

 
 
 
 

 

REGISTRATION   FORM  

28-29 April, 2006

University of Texas at  Austin

NEW  DEADLINE   April 6th, 2006  

Click for a PDF copy of this form (to be available soon!)

 

Dr. Bobby L. Barnett

Department of Chemistry
University of Cincinnati
PO Box 210172
Cincinnati, OH 45221-0172

bobby.barnett@uc.edu

 Registration Information:

 

First and Last Name (for badge)                                                                    
Affiliation (for badge)                                                                    
Mailing Address:

                                                                   

                                                                   

                                                                   

                                                                   

Phone:                                                     

E-mail:                                                        

Fax:                                                          

 

 

Accompanying person(s):  

                                                                   

                                                                   

   

            

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: Bobby Barnett - Davis Symposium and mail to the address above.

 

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

Contact Marvin Hackert at m.hackert@mail.utexas.edu for questions about local arrangements.