On-line Registration

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

Last time for submission of requests to speak is  5:00 pm on Wednesday, October 10.

Lunch reservations are needed by 3:00 PM on Monday, November 5, 2012.

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 ( $ 15)          Yes      No    

 
Lunch Reservations close at 3:00 PM on Monday, November 5, 2012.

(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
 
   

Back to CANMRDG Home Page