Submissions are no longer being accepted.

Either send this information by email to the address below or print it off and post it to the address below.

Name                                                                                                        

School                                                                                                      

Address                                                                                                    

Phone                                                                                                      

Email                                                                                                        

Indicate Appropriate Category:
    Teacher         Senior         Junior         Other

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?
    Yes             No

To assist us in arranging roommates, please indicate your gender:
    Female         Male

Campus Tours are available from 2:30 - 3:30. Would you like to participate?
    Yes         No     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):

Choice #1:                 Choice #2:                 Choice #3:                

Return this form by September 14, 2007
  Via email to cheminfo@unl.edu
  Via fax to Chemistry Day at (402) 472-9402
  Via mail to Chemistry Day, 516 Hamilton Hall, Lincoln, NE 68588-0304