Registration Form
Homogenization and Materials Science Conference
September 15-17, 2000
PS5566
There are three quick ways to register:
Print out and complete the registration form then:
Mail the registration form with a purchase order or check
(made payable to The University of Akron) to Continuing Education, Polsky 466, The
University of Akron, Akron, Ohio 44325-4104;
call (330) 972-7577 to register using VISA, MasterCard or
Discover;
or fax a purchase order to (330) 972-7598.
Name:
Social Security Number:
University or Company:
Address:
City:
State:
Country:
Work Phone:
Fax:
Email:
Credit Card Number:
Expiration Date:
Signature:
