|
Family Name: ___________________________________
First Name: _____________________________________
Dept: __________________________________________
Inst: ___________________________________________
St: ____________________________________________
City: __________________________________________
St/Prov: _____________ Zip/Postal
Code: ____________
Country: _______________________________________
Phone: _________________________________________
Fax: ___________________________________________
E-Mail: ________________________________________
*Increment charged to non-members
registration may be
credited toward new member dues for 1999 by submitting
a membership application form. Registration forms must be
postmarked on or before April 5, 1999, to be eligible for
reduced registration fee. On site registration will be accepted
at the higher rate. Cancellations and requests for refunds
should be made in writing to the ACA Headquarters. For
cancellations received before April 5, 20% of the total
remittance will be deducted. Requests received between
April 6 and April 30, 1999, will be honored minus 50% of the
total remittance. Fees will not be refunded after May 1, 1999.
All prices listed are in U.S dollars and must be submitted in
U.S. dollars. Purchase orders will not be accepted. Please
make checks payable to the ACA and mail to:
ACA
Meeting Registration
P.O. Box 96, Ellicott Station
Buffalo, N.Y. 14205-0096 USA
Forms submitted via
fax must include VISA or MasterCard
payment information. Fax (716) 852-4846.
|
| Registration |
Before
April 5 |
After
April 5 |
| ___Regular
Member |
$225.00 |
$300.00 |
| ___AACG
Member |
$225.00 |
$300.00 |
| ___Retired
Member |
$90.00 |
$90.00 |
| ___Student
Member |
$90.00 |
$100.00 |
| ___Non-member* |
$300.00 |
$375.00 |
| ___Student
Non-member* |
$114.00 |
$138.00 |
| ___One-day
Member |
$150.00 |
$225.00 |
|
__S
__M __T __W __Th |
| ___One-day
Non-member |
$195.00 |
$270.00 |
| |
__S
__M __T __W __Th |
|
Registration
Total $________________ |
| Workshops Saturday, May 22 |
___
WK01 Area Detector
Technology: Strategies and
Techniques in Obtaining and Indexing Integrated Intensities |
| |
$50
for Students |
$60
all others |
| ___
WK02 Solving Structures
with SnB |
| |
$50
for all |
|
|
Workshop
Total $_______________ |
| Social Program |
Will
attend |
Will not
attend |
| Opening
Reception, Saturday, May 22 |
____ |
____ |
| YSSIG
Mentor Dinner, Sunday, May 23 |
____ |
____ |
___As
a Mentor ___As a Mentee
|
| YSSIG
Mixer, Monday, May 24 |
____ |
____ |
| Annual
Banquet, Wednesday, May 26 |
|
|
____$40 ticket
# of tickets ____
|
____$20* student
ticket # of tickets
(*available to registered
students only)
|
| Please indicate
choice of entree: _____Fish _____Beef |
| Extra Tickets |
|
|
| Opening
Reception # of tickets ____$24/each |
| YSSIG
Monday Mixer # of tickets ____$8/each |
| Monet
Exhibit & Reception # of tickets ___$25/each |
|
Social Total
$_________________ |
TOTAL REMITTANCE $___________________ |