2016 Pauling Symposium Registration Form Welcome to the 2016 Pauling Award Symposium registration form! Online Registration is CLOSED.On-Site Symposium Registration will be available at starting 12:15 on Saturday, November 12th in the Karen Hille Phillips CenterSymposium Registration: No cost Poster Session Registration: CLOSEDBanquet Registration is CLOSEDBanquet Deadline has passed: Friday, November 4th, 2016 This one form allows for symposium and poster registration as well as banquet ticket purchases. Each person should register for the symposium (no cost). In this process, undergraduate and graduate students and post-docs can sign up to present a poster (no cost). A banquet ticket can be purchased in this same form via the ACS Puget Sound Section through their Paypal account.If a group wants to purchase multiple tickets at once, simply enter the names in the text box on the form for the individuals who are covered by the payment.For more details, see the main Pauling Medal URL: http://www.plu.edu/chemistry/pauling2016/ CLOSED: Registrant Information First Name Last Name Email address PositionPlease select... Faculty / Scientist / Industry Undergraduate student Graduate student Other Phone Number xxx-xxx-xxxx Affiliation CLOSED: Optional Poster Submission for Undergraduate / Graduate / Post-Doc If you want to present a poster, click yes and then enter your poster title in the new field. The poster should follow basic ACS guidelines in a 3x4 landscape format. For additional information, contact Dr. Adam Glass (email@example.com). Will you present a poster?YesNo Poster Title (Abstracts not required) Banquet Tickets (CLOSED - despite if you choose entrees] CLOSED: Banquet options are below along with dietary needs. (Contact firstname.lastname@example.org, email@example.com, or firstname.lastname@example.org with questions.) Non-student $35 Banquet Tickets Salmon with Lingonberries, Banquet Tickets ($35) Number of tickets Braised Beef Short Ribs, Banquet Tickets ($35) Number of tickets Roasted Butternut Squash Ravioli [Vegetarian/Vegan], Banquet Tickets ($35) Number of tickets Student $20 Banquet Tickets Salmon with Lingonberries, Banquet Tickets ($20) Number of tickets Braised Beef Short Ribs, Banquet Tickets ($20) Number of tickets Roasted Butternut Squash Ravioli [Vegetarian/Vegan], Banquet Tickets ($20) Number of tickets Select Any Dietary NeedsGluten FreeVeganFood Allergies Enter Food Allergies Other dietary needs If purchasing tickets for a group, enter the name for each ticket. Total Cost (you pay the ACS Puget Sound Section via PayPal) $ Total Ticket Cost After clicking submit, you will get a confirmation page. Please print or save that information for your records. If you are purchasing banquet tickets, you will get a confirmation message from Paypal. Captcha Please enter the characters you see in this picture: Characters This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen. Need assistance with this form?