AIChE Central Florida Section AIChE

2010 PE LAWS AND RULES REGISTRATION FORM

NAME:

 

ADDRESS:

 

CITY

 

STATE

 

ZIP CODE

 

COMPANY:

 

TELEPHONE:

 

FAX:

 

E-MAIL:

 

If you are requesting PDH Credits for the Workshops or Sessions, Please list you PE License Number ( Print Clearly)

 

Note: If you are submitting more than one registration, please make copies and submit a copy of this form for each person registering.

Date

Topic

Instructor

Friday June 11,   1:00 pm -5:00 pm

Florida PE Laws and Rules

Neil Greenwood

Registration AIChE / ASME Members – Payment received by June 4th

 $50.00

Late Registration – Payment at Door

 $65.00

 You may register by faxing this form to- Robert Andrew   (863) 666-5649
Note: In order to receive Advance Registration Rates, Fees MUST be Delivered, or postmarked by Advance Registration Date

Make Check Payable to: Central Florida Section, AIChE

Register On-line via Credit card - - Please go to AIChE Web Site
Checks - Only Payable in U.S. Funds

Return Form and Check to:

American Institute of Chemical Engineers, 
Brucer Wiggins,  AIChE Treasurer
4798 S Florida Ave # 253
Lakeland, FL  33813  USA

Full details about the Convention can be found at  www.aiche-cf.org
or call Bob Andrew at (863)665-7867, treasurer@aiche-cf.org