Registration Form

2001 Southeast Theoretical Chemistry Association

(SETCA) Conference

Friday, May 18th and Saturday, May 19th.

(Please fill out and return by mail or fax (334-844-6959)

Last Name: First Name:

Phone:

E-Mail address:

Mailing address:

Institution Department:

Please circle: Student Faculty Industry Other

Presentation Information:

Please circle: (I wish to present a poster) yes no

If so, Title:

Authors (please indicate presenting author(s) with an asterisk):

I would like to reserve one or more SETCA2001 t-shirts ($7.00/each). ________Medium _______Large _______XLarge

The registration fee is $30 for everyone which includes the reception on Thursday night and the banquet on Friday night. Add $20 for each additional banquet reservation Please make the check payable to: Auburn University (SETCA 2001) and mail to:

The registration deadline for those presenting a poster is May 14th. However early receipt of registration forms will greatly aid in planning. Please see our web site: http://www.auburn.edu/~mckeeml/setca2001.html