25th Biennial Conference on Chemical Education PARTICIPANT REGISTRATION
Sunday, 07/15/18 08:00 AM -
Thursday, 08/02/18 05:00 PM
Please fill out the registration information below.
Please choose your registration type from the choices below.
CANCELLATION POLICY: A written notification of cancellation must be postmarked or received via US Postal Service surface mail or fax by the BCCE conference staff on or before June 1, 2018 for a refund minus a $50 handling fee. NO REFUNDS WILL BE GIVEN AFTER JUNE 2, 2018.
Early Registration (until June 1st)
Early Secondary Educators Registration (until June 1st)
Early College/Graduate Student Registration (until June 1st)
Early Retiree Registration (until June 1st)
K-8 Day, All day Monday, June 30 ($0 with Scholarship Application)
Is this your first BCCE?
Are you a member of ACS?
Member of ACS:
Have you joined the ACS since the last BCCE?
Are you a member of Division of Chemical Education?
Member of Division of CE:
Are you a member of ACCT?
Member of AACT:
Please provide your Institution/Company/Affiliation's Full Address
Institution/Company/Affiliation's Full Address:
Emergency Contact Information:
Please provide your emergency contact Information.
Emergency Contact: Full Name:
Emergency Contact: Relationship to Registrant:
Emergency Contact: Main Phone Number:
Emergency Contact: Cell Phone Number:
Emergency Contact: Email:
Please provide any dietary needs we should be aware of.
Registrant's Dietary Needs:
No Dietary Restrictions
Other, please list below
Registrant's Dietary "other":
Please contact me regarding special requests. (Hold down the "Ctrl" key to choose multiple or type in the box provided)
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Authorization to Share my Information:
Some exhibitors and sponsors may want to send you information about their booths and products prior to the start of the BCCE. The BCCE will provide your contact information UNLESS you check this box to opt out.
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Review the information above and submit form to continue.
Note: Fields indicated by a red asterisk are required and must be completed in order to proceed.
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