Department of Chemistry

Celebrating Our 125th Anniversary

Chemistry Day Registration Form

Chemistry Day Schedule for Chemistry Day Chemistry Day 2007 Photos

UNL's Chemistry Day
October 11, 2008, 9:00 am - 2:30 pm
Space for participants is limited, so register as early as possible. Please let us know if you are unable to attend.

Either fill out this form and submit it or use the printable form and mail it to the address listed.

Your Information Teachers Name*
High School*
Address 1*
Address 2
City*
State*
Zip Code*
Phone*
Email*
Number of Teachers Attending*
Number of Seniors Attending*
Number of Juniors Attending*
Number of Parents Attending*
Number of Others Attending*
We will provide a limited number of hotel rooms for participants traveling more than 3 hours. Would you like for us to reserve a room for you?

To assist us in arranging roommates, please indicate your gender:
Number of Males
Number of Females
Campus Tours are available from 2:30 - 3:30. Would you like to participate?

If yes how many?

Pick your top 3 Tours from the table below (Click on a professor's name to access more information about them):

Tour A	Tour B	Tour C	Tour D	Tour E	Tour F
Cheung Du Zeng	Powers Cheung Du	Dussault Powers Cheung	Hage Dussault Powers	Choe Hage Dussault	Dumais Choe Hage
Tour G	Tour H	Tour I	Tour J	Tour K
Lai Dumais Choe	DiMagno Lai Dumais	Berkowitz DiMagno Lai	Zeng Berkowitz DiMagno	Du Zeng Berkowitz

Participants in tours are subject to change.

Special Requests

Return this form by September 19, 2008
Via email to pbergmeyer2@unl.edu
Via fax to Chemistry Day at (402) 472-9862
Via mail to Chemistry Day, 228 Hamilton Hall, Lincoln, NE 68588-0304

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Department of Chemistry

Celebrating Our 125th Anniversary

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