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The Society of Rheology Short Course
Rheology and Micro-rheological Measurements of Associating Complex Fluids
by Profs. Robert Prud'homme, William Russel and James Harden

October 11-12, 2003  —  Pittsburgh, Pennsylvania

Short Course Registration Form

    
Please type appropriate information, then print form, and mail or fax  to:  Society of Rheology Annual Meeting, CMU Conference Services, Carnegie Mellon University, Morewood Gardens E101, Pittsburgh PA 15213. Fax: (412) 268-6897.
Last Name         
First Name        Middle Initial
Institution         
Dept/Div           
Work Address  
City, State, Zip 
Country             
Phone                 Fax 
E-mail               
Registration Fee: Short course registration includes a complete set of course notes. Cancellations for the short course received in writing (CMU Conference Services, MG E101, Carnegie Mellon University, Pittsburgh PA 15213) by September 19, 2003 will be refunded minus a $30 administrative charge. Cancellations after September 19, 2003 will only be refunded if the course is overbooked and the seat is refilled (again, subject to a $30.00 administrative charge).
Check the appropriate box: Before/On 9/19/03 After9/19/03+ Registration Fee
  $
  
Total Enclosed
  $
Member $450 $550
Non-Member (incl. membership for 2004)
       decline membership (same reg. fee)
$505* $605*
Student Member $250 $325
Student Non-Member
      (includes student membership for 2004)
$275* $350*
Please indicate number of non-attendees who will accompany you - 
* Non-members who are registered to attend the 75th Annual Meeting may register for the short course at the member rates.
+ Although every effort will be made to provide course materials for all participants at the start of the course, those registering late may not receive course materials on time.
Method of Payment:
Check or money order
(payable to Carnegie Mellon University)
MasterCard
Visa
Cardholder: Card #: Exp. Date:
Authorized Signature (required for credit card transaction):
Registrations will be confirmed by e-mail and receipts will be available at registration. Attendees will pay their own room, tax, and incidentals incurred by them at hotels. The federal tax identification number of The Society of Rheology is 13-620-3476.
  
The course will begin at 8:30 AM on Saturday, October 11, 2003.
Special
Requests  
For participation in the short course
For dietary requirements
Registrant Application for Membership in The Society of Rheology:  Please complete the rest of the form to activate the membership included in non-member registration fee. Applicant for student member should attach a copy of student ID.
Affiliation Type (check the most appropriate):          Academia          Industry          Government
   
The work address you entered earlier will appear in the membership directory. Publications will also be mailed to your work address. If you prefer to have publications mailed to a different address, please enter it below:
Mail Address    
City, State, Zip 
Country             
   
Members receive the Rheology Bulletin, the Journal of Rheology (6 issues), and Physics Today (12 issues). A member subscription to the Journal of Rheology is only for your personal use. By your signature below, you agree not to loan or give any issues of this journal to a library or other lending institution without written permission from The Society of Rheology.
Signature (required):           Date: