54th Conference on Chemical Research
"Green Chemistry and Sustainable Energy"

 I will attend the conference.
 I will attend the complimentary luncheon on Tuesday, October 26, 2010.
     (Lunch requests made after 10/11/10 are not guaranteed.  Please come to the
       registration area at the conference when you arrive for further information.)

Dr. Mr.	Last Name	First Name	MI
Mrs. Miss

Position
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City	State ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY  Zip
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Where did you hear about our Conference? (Please choose)Conference PostcardC&EN MagazineWelch PosterWelch WebsiteWord of Mouth>Other

The conference is open to all and there is no registration fee. Advance registration will be acknowledged and accepted in order of receipt, to within the capacity of the available space. Please make your hotel reservations directly with the Hilton Houston North Hotel.  Reservations made prior to September 24, 2010 will receive the event rate. Reservations made after that date will be at the prevailing hotel rate. Their telephone number is 1.800.445.8667 or 281.875.2222.

Please send this form by Monday, October 11, 2010 for pre-registration.