The Society of Rheology 75th Annual Meeting
October 12 - 16, 2003  —  Pittsburgh, Pennsylvania

Annual Meeting 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: Conference registration includes access to all technical sessions and the vendor display, the program and abstract booklets, receptions, coffee breaks, and refreshments at the poster session. The registration fee does not include the Banquet, which is subject to limited seating. Please indicate the number of tickets you are purchasing for this event. Cancellations received in writing by September 19, 2003 will be subject to a $30 administrative charge. No refunds will be granted after that date.
Check the appropriate box: Before/On  9/19/03 After 9/19/03 Registration Fee
  $
  
Banquet Tickets
  $
  
Total Enclosed
  $
Member $125 $160
Non-Member (incl. membership for 2004)
       decline membership (same reg. fee)		 $180 $240
Student Member $35 $45
Student Non-Member
      (includes student membership for 2004)		 $60 $80
Retired Member $35 $45
Banquet Ticket -  indicate number of tickets:
    Meat,  Fish,  Vegetarian		 $55 each $65 each
Please indicate number of non-attendees who will accompany you - 
Method of Payment:
Check or money order
 (payable to Carnegie Mellon University)
Printed 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.
Special
Requests   		For participation in the meeting
 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: