Note to Web users: Please print this form locally, fill out, and mail or fax to the address indicated.
Do not E-Mail the completed form (payment information is insecure and a signature is needed for credit card payment).
If your web browser printing of this document is unusable, E-Mail: James L. Steele.
REGISTRATION FORM
Second International Wheat Quality Conference (IWQC-II)
Holiday Inn-Holidome
Manhattan, Kansas, USA
May 20-24, 2001

Please type or print in black ink:
________________________________  ____________________________ _________
Last Name(Mr./Ms./Dr.)            First Name                   Initial
________________________________________________________________________
Affiliation/Job Title
________________________________________________________________________
Address
___________________   __________________   __________   ________________
City                  State/Province       Country      Zip/Postal Code
___________________   ___________________  _____________________________
Phone Number1         Fax Number1          E-Mail
1 - Please include country and city codes for outside the North American Continent.

Guest Names2

______________________________   _____________________________  ________
Last Name                        First Name                     Initial
2 - Guest Registration is free of charge.  All guests are welcome to attend social functions,
    please however, reserve your guest tickets with purchase and payment below.

Names for Badge(s)

____________________________________  __________________________________
Registrant                            Guest

IN CASE OF EMERGENCY, CONTACT:
________________________  ___________________________  _________________
Name                      Location                     Phone Number

[ ]    Please indicate any health related dietary requirements or
       preferences:_____________________________________________________

[ ]    If you have specific needs or require special accommodations to
       fully participate in this Conference, please check here.  You will
       be contacted by someone from the planning committee to discuss your
       specific needs.

TOUR INTEREST: (Thursday, p.m., May 24th)          Plan to participate:
       Tour                                                 Yes      No
Grain Science Dept., KSU                            Number ____    ____
American Institute of Baking                        Number ____    ____
USGMRL, USDA-ARS                                    Number ____    ____

REGISTRATION FEES AND FUNCTIONS:

Professional        _ Date of Receipt         U.S. Dollars  Selection

  I. Early Bird:      before  January 15, 2001     $300.00     $________
 II. Preregistration: before February 15, 2001     $400.00     $________
III. Regular:         after  February 15, 2001     $450.00     $________

Student3

  I. Early Bird:      before  January 15, 2001     $ 60.00     $________
 II. Preregistration: before February 15, 2001     $ 75.00     $________
III. Regular:         after  February 15, 2001     $100.00     $________

FULL REGISTRATION FEE INCLUDES THESE FUNCTIONS:   Do you plan to attend?
                                                            Yes      No
1 Welcome Reception, Buffet Dinner (May 20, evening)         ___     ___
1 Dinner (May 21, evening)                                   ___     ___
1 Dinner (May 22, evening)                                   ___     ___
1 Banquet (May 23, evening)                                  ___     ___
3 Lunches (May 21, 22, 23)                                   ___     ___
7 Breaks (Coffee, Tea, Soft Drinks)
1 Conference Proceedings (Full Papers of Oral Presentations and
     Abstracts of Poster Presentations)

3 - Special Student Registration fees include all of the above functions, except the Banquet (May 23).
    Student fee discounts require Institutional or Advisor signature below for student certification.
__________________  ____________________  _________________  ___________
Dept. Head/Advisor  (print and sign)      Dept./Institution  mo/day/year

FOR SPECIAL ONE/TWO DAY REGISTRATION, COMPLETE THE FOLLOWING:
Option     S  M  Tu W  Th       Date of Receipt      Fee4      Selection
========================================================================
One day    __ __ __ __ __    Before Feb. 15, 2001   $150.00
One day    __ __ __ __ __     After Feb. 15, 2001   $180.00    $________

Two day    __ __ __ __ __    Before Feb. 15, 2001   $300.00
Two day    __ __ __ __ __     After Feb. 15, 2001   $360.00    $________

                        SUB-TOTAL IWQC-II REGISTRATION FEES    $________

4 - These fees include the corresponding daily breaks and lunches and one copy of the
    Conference Proceedings, but do NOT include admission to any evening function.  For these
    registration fees, purchase a ticket below for the desired evening function.
 
 
 
 

EXTRA GUEST TICKETS AND PROCEEDINGS:

  Day      Function/Item                  Number   Cost/person     Total

  Sunday    Welcome Reception-Dinner      ______     $30.00     $________
    Monday    Evening Dinner                ______     $30.00     $________
  Tuesday   Evening Dinner                ______     $30.00     $________
  Wednesday Banquet                       ______     $45.00     $________

             Proceedings                  ______     $60.00     $________

                       SUB-TOTAL GUEST TICKETS AND PROCEEDINGS  $________

M & B DIVISION LUNCHEON AND GOLF SIGN-UP:

IWQC-II             M&B Division    Golfing      Luncheon     Golfing Fee
Registrant Name     Member(yes/no)  Nickname       US $25       US $95
__________________  ______________  ___________  $__________  $__________
__________________  ______________  ___________  $__________  $__________

                 SUB-TOTAL M & B DIV. LUNCH AND GOLFING FEES  $__________

PAYMENT
PAYMENT MUST ACCOMPANY REGISTRATION FORM

Payment in U.S. funds only.  Checks must be drawn on a U.S. Bank.
Payment recap: SUB-TOTAL IWQC-II REGISTRATION FEE  ............. $_______
               SUB-TOTAL EXTRA GUEST TICKETS AND PROCEEDINGS  .. $_______
               SUB-TOTAL M & B Div. LUNCH AND GOLFING FEES  .... $_______5

                                             TOTAL SUBMITTED  .. $_______

  [ ] Check No. ________ enclosed (Make payable to IWQC-II)

   or charge my credit card:  [ ] Master Card    [ ] Visa Card

  Name of Cardholder ___________________________Expiration Date _________
                                                                (mo/year)
  Card Number:
       [  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ][  ]
         1   2   3   4   5   6   7   8   9  10  11  12  13  14  15  16

       Signature_______________________________   Date___/___/_____
                                                     (mo/day/year)
5 - See AACC Milling and Baking Division Meeting announcement at end of IWQC-II Program.

Advance registrants will receive confirmation within three weeks of receipt of registration payment. No refunds after March 30, 2001.  Refunds are available by
written request before March 30, 2001.  A $50.00 refund handling charge will be assessed.


Mail or fax form and payment to: Ms. Marsha Grunewald
                                 GMPRC, USDA-ARS
                                 1515 College Avenue
                                 Manhattan, KS  66502, USA
                                 FAX: 785-537-5534

Do not E-Mail form and payment, only forms with credit card information will be processed via fax.

For further registration or IWQC-II information, contact: Ms. Marsha Grunewald,
Ph: 785-776-2757, E-Mail: Marsha Grunewald <marsha@usgmrl.ksu.edu>



Last update: January 26, 2001 2:00pm jlsteele