EPR 2007
A Joint Conference of
12th In Vivo EPR Spectroscopy and Imaging
9th International EPR Spin Trapping/Spin Labeling

Registration

You may register by either printing the Registration Form (pdf) or by submitting the form below and mailing in your payment.

Name as it should appear on nametag:
or Other:      Name:     Degree:
Institution:      Div/Dept:
Address:
City:      State/Province:      Postal Code:
Country:
Phone:      FAX:
Email Address:
Verify Email Address:
Guest name: or Other: Name:

Number of abstracts submitted (Call for Abstracts): poster      oral

Please indicate all of the dates you plan to attend EPR 2007:
Sunday 4/29      Monday 4/30      Tuesday 5/1      Wednesday 5/2      Thursday 5/3

The Wednesday evening Banquet is planned at the Signature Restraurant on the 95th floor of the John Hancock building, with a panoramic view of the Windy City.

If you have any special requirements (dietary, parking, access), please note them below and we will do our best to accommodate them.

Registration Fee: U.S. $700

Fee includes EPR 2007 conference registration, booklet, bag, daily continental breakfast, all breaks, Sunday welcome reception, Wednesday banquet dinner, and CE credits.

Guest Fee: U.S. $250

Fee includes Sunday welcome reception and Wednesday banquet dinner.

Method of Payment:
check (drawn on a U.S. bank, in U.S. currency) money order/travelers check	}	payable to: Xxxxxxxx College
institutional purchase order #
credit card payments

Cancellations received by 3/31/07 will be refunded less 25%; after 3/31/07 no refund can be given. These monies will be refunded after the conference.

Questions? Please call 999-999-9999 if you need additional information	Please submit payment:
	via mail:	Xxxxxxx Xxxxxxxxxx, Ph.D., Treasurer, EPR2007 Department of Xxxxxxxxx, Xxxxxxx College 9999 Xxxxxxx Road, Milwaukee, WI USA
	On-site registrations will also be accepted.