2013 II-VI WORKSHOP REGISTRATION FORM
U.S. Workshop on the Physics and Chemistry of II-VI Materials
Embassy Suites Lakefront, Chicago, Illinois
October 1-3, 2013

 

CONFERENCE REGISTRATION

First Name
Middle Initial
Last Name
Informal Name

Job Title or Rank

Company/Government Agency/University

Affiliation Address (Street/Avenue)

City
State
Zip Code
Country

Phone Number
Fax Number
E-Mail

Advance Registration Must Be Received By September 13, 2013
$750 Registration Fee* w/ Soft-Cover Proceedings (Industrial, Government, or University)
$790 Registration Fee* w/ Hard-Cover Proceedings (Industrial, Government, or University)
$150 Full-Time University Student Fee* w/ Soft-Cover Proceedings (With proper identification)
$190 Full-Time University Student Fee* w/ Hard-Cover Proceedings (With proper identification)
Additional Proceedings

Soft-Cover Qty  @ $50.00 

 Hard-Cover Qty  @ $90.00 

* Fee includes lunches, refreshments, a copy of the Book of Abstracts, and a copy of the Proceedings.
Yes, I will attend:  
Monday Tutorial 
TuesdayBreakfast  TuesdayLunch  TuesdayNight Reception
WednesdayBreakfast  WednesdayLunch  
ThursdayBreakfast  ThursdayLunch

Please specify your meal requirements: Vegetarian  Other

Please check one of the following:  Industrial  Government  University  Non-U.S. Attendee

Payment Method
Credit Card: VISA MasterCard AMEX
Card Number: Expiration Date (mm/yyyy):
  /
Card Holder's Name:
Credit Card Billing Address Zip Code:

Please direct any inquiries to Mark Goldfarb at 1-800-350-0111 or 1-212-460-9700 or [email protected].

For a copy of the 2013 II-VI Workshop Advance Program, please visit the official II-VI Website at www.ii-viworkshop.org