February 17 - 20, 2013
Asilomar Conference Grounds
Pacific Grove, California USA

REGISTRATION
Register

To register send the completed registration form with remittance to Lesia Linkous, Division of Polymer Chemistry, Inc., Virginia Tech, 103 Surge Bldg., M.C. 0279, Blacksburg, VA 24061.  Phone:  540-392-3042, Fax:  540-231-2588, E-mail:  lesiar@vt.edu

 

Registration form and bank transfer information is available by clicking here

or

 

simply copy the below information, place it in the body of an email, and send to Lesia Linkous at lesiar@vt.edu


Prof.    Dr.      Mr.       Ms.      Mrs.     Miss

Name                                                                                                    
Organization                                                                                        
Mailing Address                                                                                  
City                                                    State                Zip                     
Country                                                                                                 
Phone                                                Fax                                             
E-mail                                                                                                   
__   $675 Member Registration
__   $725 Non-Member Registration
__   $175 Member Student Registration
__   $225 Non-Member Student Registration

__    $50 Late Fee (after January 8, 2013)
Total Amount Due:  $                                                                          

Payment by:          __  Check              __  Credit Card

          __VISA              __MASTER CARD             __AMEX  

Exp. Date                                                                                               
Account #                                                                                             
Signature