NJ Group of Small Chemical Businesses - Register for a Meeting

American Chemical Society

Meetings

Registration (or cancellation) Form

Use this form to register (or to cancel an earlier registration).
Or you may call Pete Sibilski at (732)254-1901 Ext.140

Advance Registration is necessary to guarantee you a place at the table.
The hotel can accommodate only a limited number of walk-ins.

Cancellations must also be made by EOB Monday, Sept 17th, or you will be invoiced.

Registration fee:
$45 Members
$55 Non-Members

You must both register (below), and visit our [ payment form ] to make payment arrangements.

Registration Form for Sept 20, 2007 Meeting ( to Register or Cancel )
Purpose	(required)
How did you hear about this meeting?	(required)
Name(s): (required)	E-Mail(s): (required)
Note: Multiple names must be from the same company.
Company/Affiliation	(required)
Street Address
City, State, Zip
Phone	(required)
Please add me / us to your E-Mail List	yes no
Please review the above data for accuracy before submitting

After registering, don't forget to visit the [ payment form ] to make payment arrangements.

If you have any questions about Registration or the Meeting, please contact Pete Sibilski, Program Director,

If you have any difficulties in using this form, please contact the

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