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173 rd

2YC3 EXHIBIT REQUEST

 March 23-March 25, 2006

Firm / Exhibitor's Name:                    

Street  Address :           

City:                                 

State:                                                   Zip:       

Exhibitor's Representative at Conference 

   Dr.       Mr.    Ms.     Miss     Mrs.

 Name:   

 Title:                      

Address (local, if possible)

                

Telephone

Area Code -     Number-   Ext.-

1.   Nature of exhibit or description of items to be displayed

   

 

2.   Space required for exhibit (square feet of table top)     sq. ft

           

3.   Services required:  Gas   Water    Electricity   (Approx. amps at 115 volts)



*Please note that depending upon the host institution and the area provided for exhibits, it may not always be possible to provide gas and water.

You will need to furnish your own industrial gases such as helium, nitrogen, oxygen, carbon dioxide, or others specific to your needs.

 

4.   Special requirements

   

 

Click the submit button to email this form to Dr. Glenn S. Nomura, 173 rd Two-Year College Chemistry Consortium Program Chair:


Within the limits of the facilities available, we will endeavor to meet your requirements.
Please return this form as soon as possible, but no later than March 1, 2006

Glenn S. Nomura, Ph.D.
Associate Professor of Chemistry
Georgia Perimeter College
Science Department – Dunwoody Campus
2101 Womack Road
Dunwoody, Georgia&
gnomura@gpc.edu
http://www.gpc.edu/~dunsci/chem.htm


All further correspondence relative to your exhibit should be directed to the above person.

UPON RECEIPT OF THIS FORM, YOU WILL BE SENT AN ACKNOWLEDGMENT OF YOUR REQUEST TO EXHIBIT, TOGETHER WITH FURTHER INFORMATION REGARDING THE SHIPPING OF EXHIBIT MATERIAL AND SETTING UP YOUR EXHIBIT.
 

 
   

Georgia Perimeter College
2101 Womack Road
Dunwoody, GA 30338
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page last updated 21 February, 2006 06:07 PM