Credit Card Registration Form
for
Conference on Lyophilization - Freeze Drying - September 16 - 19, 2003
and
Pre-Conference Lyophilization Seminar and Workshops

Oak Briook Hills Resort  The seminar, workshops and conference will be held at the Oak   Brook Hills Resort, Chicago, IL USA. Please note that you need not   complete this form now in order to take advantage of the "special"   room rate which is subject to change after June 14, 2003 provided   you make your room reservation at this time. Click on the picture for   more information about the hotel and making hotel reservations.

Maximin Attendance to the Conference is 145 persons

Registration will be strictly on a first come first serve basis

     Conference = Complete admissions to all Conference sessions, reception, Chicago tour, exhibits                             and  banquet. Fees=$1795.00.

     Seminar = Three day Lyophilization Seminar by Dr. Thomas A. Jennings - USA Fees=$1995.00                         Deadline for Registration is August 29, 2003

     Seminar  + Conference.   Fees=$2995.00.

     Workshop A = Lyophilizers Commissioning and Validation - Miquel Galán - Spain. Fees=$695.00
                              
     Workshop A  + Conference. Fees=$2295.00.

     Workshop B =  Sterilization Of Freeze-Dryers - Dr. Kevin Murgatroyd - United Kingdom=$695.00
                              
     Workshop B + Conference=$2295.00

     Workshop C =  Leak Detection - Peter Leare - United Kingdom. Fees:=$695.00
                                
     Workshop C + Conference=$2295.00

     Workshop D = Maintenance of Freeze Dryers Lawrence A. Ulfik - USA. Fees:=$695.00
                              
     Workshop D  + Conference. Fees=$2295.00

     Workshop E=Contract Manufacturing of Lyophilized Products - Dr. Wilhelm Scigalla and
                                                                                                                  Dr. Narlin B. Beaty
Fees:=$695.00
                             
     Workshop E + Conference. Fees=$2295.00

Special Fees for Student, Member of a Faculty or Government employee (US or any other country)

     Conference = Complete admissions to all Conference sessions, reception, Chicago tour, exhibits                             and  banquet. Fees=$1095.00.

     Seminar = Three day Lyophilization Seminar by Dr. Thomas A. Jennings - USA Fees=$1000.00
     Seminar  + Conference.   Fees= $2095.00

     Workshop A = Lyophilizers Commissioning and Validation - Miquel Galán - Spain. Fees=$420.00
                              
     Workshop A  + Conference. Fees=$1500.00

     Workshop B =  Sterilization Of Freeze-Dryers - Dr. Kevin Murgatroyd - United Kingdom=$420.00
                              
     Workshop B + Conference=$1500.00

     Workshop C =  Leak Detection - Peter Leare - United Kingdom. Fees:=$420.00                                                              
     Workshop C + Conference=$1500.00

     Workshop D = Maintenance of Freeze Dryers Lawrence A. Ulfik - USA. Fees:=$420.00
                              
     Workshop D  + Conference. Fees=$1500.00

     Workshop E=Contract Manufacturing of Lyophilized Products - Dr. Wilhelm Scigalla and
                                                                                                                  Dr. Narlin B. Beaty
Fees:=$420.00
                               
     Workshop E + Conference. Fees=$1500.00

Credit Card Registration Form

             Please check the box for programs of the conference that you intend to pay by Credit Card. It should be noted that we will only accept American Express, Master Card or Visa credit cards. When you have completed this registration form you, please press the Continue to Secure Payment Form button. You will be transferred to a secure web site where you will be required to enter you credit card information.

     Registration Information (Please complete the following)

     Your full name:   As it appears on credit card

    Attendee :           Name of Attendee if not the same above

     Family member:   Enter "None" if no family member will be with you

     Your Username:  Enter "None" if you are not yet a Society member.

      Street Address:

     Suite or Apt.:      

     City:                        

     State:                    US residents only (Residents of Puerto Rico please                                                                           go to "Outside US")

    Outside US:             (State or Province outside the United States)  
                                                                              Format: State or Province
                                                                              Example: Quebec

     Zip Code:               If your country does not use zip codes leave this box blank

     Country                  US residents use "US". Residents of other countries and Puerto Rico                                           please find and  click on name of your country from the the following pull down lists.

                Africa                                                  Asia                                                   Australia    
                                               

                  Caribbean                                 Central America                                       Europe                
                                    
     

               Middle East            North America          South America                           Others
                              

     Telephone No.  

     Fax No.              

     E-Mail Address:

         Click on link only if you qualify for special fees for a Student, Member of a Faculty or Government           employee (US or any other country)

         Important: Please note that you cannot register for the seminar and a workshop. The last day of the                             seminar falls on the same day that the workshops are given.

          Please press the button to indicate which of the following programs that you wish to attend. (Note you           will only be able to select just one button.)

Conference
            Conference only = $1795.00

Seminar
            Lyophilization Seminar=$1995.00
            Lyophilization Seminar + Conference = $2995.00

Workshops
            Workshop A (only) = $695.00
            Workshop A + Conference = $2295.00
            Workshop B (only) = $695.00
            Workshop B + Conference = $2295.00
            Workshop C (only) = $695.00
            Workshop C + Conference = $2295.00

            Workshop D (only) = $695.00
            Workshop D + Conference = $2295.00
            Workshop E (only) = $695.00
            Workshop E + Conference = $2295.00

Important: Please confirm your Program selection by selecting it from the following drop box. We cannot know which of the above you selected unless you inform by click on the selection that you made above. Your selection must appear in the box before you proceed with the registration

                                                           

[Click here to Go To Important Registration Information]

Special fees for a Student, Member of a Faculty or Government employee (US or any other country)

    Enter the Name of University or Government Agency:    

    Enter the Name of the Department:                        :            

          Please press the button to indicate which of the following programs that you wish to attend. (Note you           will only be able to select just one button.)

Conference
            Conference only = $1095.00

Seminar
            Lyophilization Seminar=$1000.00

            Lyophilization Seminar + Conference = $2095.00

Workshops
            Workshop A (only) = $420.00
            Workshop A + Conference = $1500.00
            Workshop B (only) = $420.00
            Workshop B + Conference = $1500.00
            Workshop C (only) = $420.00
            Workshop C + Conference = $1500.00

            Workshop D (only) = $420.00
            Workshop D + Conference = $1500.00
            Workshop E (only) = $420.00
            Workshop E + Conference = $1500.00

Important: Please confirm your Program selection by selecting it from the following drop box. We cannot know which of the above you selected unless you inform by click on the selection that you made above. Your selection must appear in the box before you proceed with the registration

                                                           

     Important Registration Information - Please read before you register.

Please check your Registration Form. Make sure you have All completed appropriate sections. Printout a copy of the form for your records. You may make corrections by pressing the Reset button and re-enter your information. To submit your registration just click on the Continue to Secure Payment Form button.

                    

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