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Graduate School Recruiters Meet motivated chemistry undergraduates and share information about your programs. Networking Social with Graduate School Recruiters at the 253 rd ACS National Meeting San Francisco, CA | April 2, 2017 | 1:00 – 5:00 p.m. REGISTRATION DEADLINE: March 11, 2017 Register by January 9, 2017, to save $50!

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Page 1: Microsoft Word - recruiter_ p.m. REGISTRATION DEADLINE: March 11, ... ☐Ph.D. ☐Master’s ☐Professional Master’s ☐ Other ... Microsoft Word - recruiter_ · Web view · 2016-10-20

Meet motivated chemistry undergraduates and share information about your programs.

Networking Social with Graduate School Recruiters at the 253rd ACS National

MeetingSan Francisco, CA | April 2, 2017 | 1:00 – 5:00 p.m.

REGISTRATION DEADLINE: March 11, 2017Register by January 9, 2017, to save $50!

Graduate School Recruiters

Page 2: Microsoft Word - recruiter_ p.m. REGISTRATION DEADLINE: March 11, ... ☐Ph.D. ☐Master’s ☐Professional Master’s ☐ Other ... Microsoft Word - recruiter_ · Web view · 2016-10-20

Event RegistrationThe registration fee is $249 prior to January 9, 2017. Registration will increase to $299 starting January 10, 2017. The information below will be shared with undergraduate meeting attendees and used to update our records. Please complete one form for each table you require.

Institution: Click here to enter text.Representative’s name(s): Click here to enter text.

Department, program, or specialty represented: Click here to enter text.

Department, program, or specialty URL: Click here to enter text.

Degree(s) offered:☐Ph.D. ☐Master’s☐Professional Master’s ☐ Other (specify): Click here to enter text.

Mailing address: Click here to enter text.City/State/ZIP: Click here to enter text.

E-mail: Click here to enter text. Phone:Click here to enter text.

Wi-fi AccessPrior to January 9, 2017, you may purchase Wi-Fi access for $20 per device. Starting January 10, limited access to Wi-Fi may be purchased on a first-come, first-served basis.

Please note that separate Wi-Fi access must be purchased for each device used.

Payment total, through January 9, 2017Option Amount Enter amount owed☐ Registration $249.00 Click here to enter text.

☐ Wi-Fi connection$20.00 x Click here to enter text. (# devices) Click here to enter text.Total amount owed: Click here to enter text.

Payment total, January 10–March 11, 2017Option Amount Enter amount owed☐ Registration $299.00 Click here to enter text.

☐ Wi-Fi connection (if available)$20.00 x Click here to enter text. (# devices) Click here to enter text.Total amount owed: Click here to enter text.

Method of Payment The total amount owed (above) may be paid by one of the following methods:☐ Check☐ Purchase order

1) Email registration form to Blake Aronson ([email protected]) by March 11, 2017.2) Submit payment/forms to: Robin Lindsey, Undergraduate Programs Office,

American Chemical Society, 1155 Sixteenth St. NW, Washington, DC 20036-4839

☐ Visa☐ MasterCard☐ American Express

Card number Click here to enter text.Expiration date Click here to enter text.Cardholder name Click here to enter text.

SignatureEmail completed form to Blake Aronson ([email protected]) by March 11, 2017.

Check and credit card payments must be received by March 11, 2017.Purchase order payments must be received by April 30, 2017

Networking Social with Graduate School Recruiters Registration Form253rd ACS National Meeting, San Francisco, CA, April 2, 2017

mailto:[email protected]
mailto:[email protected]

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