Meeting Registration Form — CHIRALITY-2001

July 15 – 18, 2001
Orlando, Florida, USA

Name ___________________________________________________________________________________
(First) (Last)

Company ________________________________________________________________________________

Department ______________________________________________________________________________

Address _________________________________________________________________________________

City _____________________________________ State ________________ Zip Code __________________

Country __________________________ E-mail # ________________________________________________

Phone # _________________________________________ Fax # __________________________________

REGISTRATION FEE:
 
 
Full
One-Day† 
Student*
Banquet Dinner
Short Course‡ 
Total
By: May 18
$550
$280
$100
$50
 $270
  
By: June 28
$575
$300
$100
$50
 $270
  
Onsite & after 
June 28, '01
$600
$320
$100
As available
 $270
  

† ONLY one-day registrants indicate day: o Sunday o Monday o Tuesday o Wednesday

‡ SUNDAY SHORT COURSES: Registrant Indicate Short Course (Space limited and assigned on first-come, first-serve basis)


*Student registrants must attach to this form verification of current full-time graduate or undergraduate, not post-doctoral, status at an academic institution by providing a copy of your Student I.D. and a letter from your department chairman on University stationery.

CHECK Payable to Chirality-2001 — check must be drawn on a U.S. bank and payable in U.S. dollars

(OR)

MasterCard / Visa # ____________________________________________________ Expires ____________

Name as printed on credit card _____________________________________________________________

Signature ________________________________________________________________________________
(The cardholder, by signing this form, hereby authorizes Barr Conferences to charge this credit card on behalf of the registrant named above.)

—Registration form must be accompanied by check, money order, or MasterCard or Visa card number with signature
—Registration will only be confirmed once payment is received
—Registration with credit card information may be FAXed to 301-898-5596
—Refund Policy: Must cancel in writing before May 25, 2001 to receive refund ($100 service charge deducted)

Return Form & Payment to: Ms. Janet Cunningham
Chirality-2001 Symposium Manager
Barr Enterprises
P. O. BOX 279 (10120 Kelly Road)
Walkersville, Maryland 21793 USA
www.chiral.com
F 301-668-4312
P 301-668-6001
E janetbarr@aol.com