REGISTRATION

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If you would prefer to communicate directly with the Polymer Division Business Office, send your correspondence with remittance to Lesia Linkous Pristas, Division of Polymer Chemistry, Inc., Virginia Tech, 103 Surge Bldg., M.C. 0279, Blacksburg, VA 24061.  Phone:  540-231-3029, Fax:  540-231-2588, E-mail:  lesiar@vt.edu. Simply copy the below information and place it in the body of an email to Lesia:

Prof.    Dr.      Mr.       Ms.      Mrs.     Miss

Name                                                                                                    
Organization                                                                                        
Mailing Address                                                                                  
City                                                    State                Zip                     
Country                                                                                                 
Phone                                                Fax                                             
E-mail                                                                                                   
__   $750 Member Registration
__   $800 Non-Member Registration
__   $250 Member Student Registration
__   $300 Non-Member Student Registration

__    $50 Late Fee (after January 13, 2017)
Total Amount Due:  $                                                                          

Payment by:          __  Check/Transfer              __  Credit Card

          __VISA              __MASTER CARD             __AMEX  

Exp. Date                                                                                               
Account #                                                                                             
Signature/CVS                                                          

Cancellations (if already charged) and registrations after the deadline will be charged a $50.00 late fee.

Registration Deadline January 13, 2017!