Complete and return this form by October 22, 2001 either through this website or by mail to Stephanie Stathopoulos, Department of Chemistry, University of Minnesota, 207 Pleasant Street S. E., Minneapolis, Minnesota 55455 or fax to (612)626-7541.

 

Contact Person

Representing

Address

Phone Number(s)

Fax Number

email address

We intend to present:

Number of box lunches needed

Space is available in either a teaching lab or the corridor. Which would you prefer?

Indicate how many of which of the following you need:

Tables (4' x 8')

Chairs

Easels

Electrical Outlets

VCR/Monitor (VHS or Beta)

Computer (IBM or Mac)

Overhead

Other

Will you be providing material for door prizes?Yes    No
If yes, please be sure to bring them the day of the event

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