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Lehigh Microscopy School 2014 Registration Form

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Name
Company
Address 1
Address 2
City   State
ZIP   Country
Phone   Email
           
Please indicate choices below by clicking on appropriate boxes:          
           
Main Course Dates

Regular Rate

Early Rate (paid in full by April 15)
SEM and X-ray Microanalysis June 9-13 $3250 $2950
New Operator Introduction
(Includes lunch and dinner)
June 8 $950 $900
           
Specialized Courses          
FIB Applications June 9-12 $2900 $2660
Problem Solving June 9-13 $3250 $2950
Quant X-ray Microanalysis June 9-13 $3250 $2950
Scanning Transmission EM June 9-13 $3250 $2950
Total Course cost
   
Lodging (All rooms are nonsmoking)  
Lodging is available Saturday, June 7, through Friday, June 13, at $76/night  
Arrival Date
Departure Date
Total number of nights
Total lodging cost (nights x $76)
Gender male female
       
Meals

Dates

 

Cost  
SEM and X-ray Microanalysis June 9-13 $330
FIB Applications June 9-12 $305
Problem Solving (SEM/EDS/EBSD) June 9-13 $330
Quant X-ray Microanalysis June 9-13 $330
Scanning Transmission EM June 9-13 $330
Total Meal cost  
 
Meal choice for Wednesday banquet
Surf and Turf Filet Mignon Vegetarian
GRAND TOTAL
   
On my nametag please print my name exactly as:
On my course certificate please print my name as:
   

Please rate yourself with respect to operation of the SEM so that we can assign you a compatible lab group:

Beginners: please consider the special course on
Sunday, June 8.

Beginner
Experienced Operator
Somewhere in-between
   
Method of payment
Check in U.S. funds made payable to Lehigh University
Purchase order number
Please bill my MasterCard Visa American Express
 
in the amount of
 
Credit card number
 
Expiration date month year
 
Name as it appears on card
Billing ZIP code
   
Mailing address:
Sharon Coe
Lehigh Microscopy School
5 East Packer Avenue
Bethlehem, PA 18015-3195
Lehigh's Federal Tax I.D. 240795445/000

DUNS No. 80-826-4444

Fax: 610-758-4244
Phone: 610-758-5133
 
   
 
Lehigh University