On-line Registration

To register for the 2009 Chicago Area NMR Discussion Group meeting, please complete this form and click the submit button at the end.

Registration Forms are due by 5:00 PM on Friday, October 30th.  

To guarantee a lunch, please register no later than NOON on Friday, October 30.  
 

Title
First Name
Last Name
Email Address
Affiliation
Mailing Address
 
City, State, Zip Code
Phone Number
Fax Number
   
I will attend    will NOT attend   may attend the NMR Discussion Group Meeting
 

I plan to join the group for lunch (The price is $20 per person.
A special discount rate of $10 per person is available for students courtesy of a generous donation by a sponsor.)

          Yes      No

(Please note that no-shows will be billed for the meal cost.  We have no other way of covering expenses.)
 
I wish to speak at the Discussion Group   Yes     No

Talk Title:
 
Time Requested:

Audio Visual Needs (overhead, slides, powerpoint or equivalent video):

NOTE: Equipment MUST be requested in advance.

I wish to recommend the following speaker or topic:
Suggestions for the meeting:
Please remove my name from the mailing list    Yes   No

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