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2012 CLEARWATER CONVENTION REGISTRATION FORM |
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| NAME: | ||||||
| ADDRESS: | ||||||
| COMPANY: | ||||||
| TELEPHONE: | FAX: | E-MAIL: | |
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| If you are requesting PDH Credits for the Workshops or Sessions, Please list you PE License Number ( Print Clearly) | ||||||
| How would
you like your name to appear on the nametag? (Please Print) |
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| Date | Topic | Chair |
| Friday June 8, 1:00 pm -5:00 pm |
Sulfuric Acid Workshop | Rick Davis |
| Florida PE Laws & Rules |
John Ellington |
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| Saturday June 9, 8:00am - 1:00pm | Technical Session 1 - Phosacid & Phosphate Fertilizer Technology | Nicole Seifert |
| Technical Session 2 - Sulfuric Acid | Kai Hamang |
| Advance Registration: | May 11, 2012 |
| Member of Local Section ($20 dues paid) | US $50 (includes book) |
| Non-Member of Local Section | US $70 (includes book) |
| AIChE Student Member | US $20 (includes book) |
| Late Registration: | Until June 8, 2012 |
| Member of Local Section ($20 dues paid) | US $70 (includes book) |
| Non-Member of Local Section | US $90 (includes book) |
| AIChE Student Member | US $20 (includes book) |
Please Note: On-site
Registration will be $75.00 for Members, $100.00 for Non Members
Proceedings Book Only-
US $10 Per Copy at Meeting
You may register by faxing this form to-
Robert Andrew (863) 665-5323
Note: In order to to receive Advance Registration
Rates, Fees
MUST be Delivered, or postmarked by Advance Registration
Date
Make Check Payable to: Central Florida Section, AIChE
To use a Credit Card Click Here, On-Line Registrations
Checks - Only Payable in U.S. Funds
Return Form and Check to:American Institute of Chemical Engineers,
Robert Andrew, AIChE Treasurer
4798 S Florida Ave # 253
Lakeland, FL 33813 USA