Registration Form - 54th ACS Northwest Regional Meeting ( NORM '99 )

To register for the meeting and qualify for the advance registration fees, complete this form, print it out, and then mail it to the address provided below.
You may also fax it if you are paying by credit card.
A printed registration form is also available in the April 26 issue of Chemical and Engineering News.

Early registration amounts require receipt by June 4, 1999. (extended deadline)

Use a separate form for each registrant.
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Dr. Mr. Ms. Mrs.
Name for badge
Professional Affiliation:Local ACS Section:
Street address:
City, State, Country
Telephone (office), (home)FaxE-mail
Please check here if you have a disability that will require special accommodations. We will contact you prior to the meeting.
Type of Affiliation:1. Academic 2. Industry 3. Government 4. Student 5. Other

ADMISSION TO SESSIONS AND SOCIAL EVENTS REQUIRES A BADGE.

REGISTRATION FEES

 

Student Affiliate Members ONLY

Please specify your free tickets
Mon - 29. Student Affiliate Breakfast
Tue - 30. BanquetVegetarian?
Choice of one of the following:
Mon - 31. High School Teacher Award Luncheon @ $20Vegetarian?
Tue - 32. Women Chemists Luncheon @ $20Vegetarian?
Wed - 33. Luncheon @ $20Vegetarian?

 

SPECIAL EVENTS and FEES

Please specify number of participants/tickets
Sun - 15. Mixer at Edgefield Manor @ $30
Mon - 16. Student Affiliate Breakfast @ $15
Mon - 17. High School Teacher Award Luncheon @ $20Vegetarian?
Tue - 18. Women Chemists Luncheon @ $20Vegetarian?
Tue - 19. Banquet @ $30Vegetarian?
Wed - 20. Luncheon @ $20Vegetarian?
Mon - 21. Intel Lab Tour - June 21st @ $12
Sun - 22. Reed College Research Reactor Tour - June 20th @ $12
Sat - 23. Oregon Countryside / Winery Tour - June 19th @ $59
Sat - 24. Northern Oregon Coast Tour - June 19th @ $47
Sun - 25. Mount Saint Helens Volcano Tour - June 20th @ $55
Sun - 26. Columbia River Gorge / Mt. Hood Tour - June 20th @ $47
Wed - 27. Columbia River Gorge Tour - June 23rd @ $30
Thu&Fri - 28. Lab Safety Short Course - June24th-25th @ $355
Total Special Events     

WORKSHOPS / TOURS / EVENTS (no fee)

Please check those you plan to attend:

1. DivCHED/PROGRESS High School Teacher Workshop
Note: Supplemental application required (see the above website)
2. Student-Focused Active Learning Workshop
3. Student Affiliates Workshop
4. Lacamas Lab Tour
5. ACS Regional Employment Clearing House / Career Center
6. ACS Member Open Forum
7. Industry Relations Seminars
8. Ion Chromatography-Dionex Workshop
9. Latex Microsphere Applications in Molecular Biology - Interfacial Dynamics Workshop
10. Professional Analytical Chemists in Industry Workshop
by Procter and Gamble
11. Government Affairs Workshop
12. Kids and Chemistry Workshop
13. Wonder Science/Chem Matters Workshop
14. ACS Teaching Resources Workshop
Payment Method  
check (payable to ACS/NORM'99)  
charge my:  
Cardholder's Name
Cardholder's Signature
Card Number Exp. Date
Total Due (Registration + Special Events)      
NOTE: Full refund of registration fees will be made if written requests are postmarked by May 28, 1999. After this date, a $20 processing fee will be assessed. No refunds after June 11, 1999.
ROOM RESERVATIONS: Room reservations must be made directly with the hotel. Discount rates have been negotiated with the DoubleTree-Columbia River Hotel for those attending NORM '99. Mention that you are with the 54th Northwest Regional Meeting of the American Chemical Society when you make your reservation in order to ensure you get the discounted rate.

Return this form and payment by May 21:

Tracey Nguyen
Office of Regional Meetings
American Chemical Society
1155 16th Street, NW
Washington, DC 20036

or by FAX: (202) 872-6013 or (202) 872-6128

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