ASM Conference on Biodegradation, Biotransformation, and Biocatalysis (B3)
October 2-6, 2001
San Juan, Puerto Rico

In collaboration with the Society for General Microbiology

Demographic Information

I. Please circle your highest degree achieved:
A. Associate  B. Bachelors
C. DDS   D. DPH   E. DVM
F. Masters  G. MD  H. PhD.
I. ScD.  J. Pharm.D.

II. What is your scientific specialty? (Members write in primary division affiliation):
__________________

III. Please circle your primary job activity:
A. Teaching  B. Research
C. Administration 
D. Diagnosis & Testing
E. Product Development/ Quality Control  F. Consulting
G. Clinical Practice  H. Sales & Marketing

IV. Please circle your type of employer:
Clinical/Medical:
A1. Hospital Diagnostic Laboratory 
A2. Private Diagnostic Laboratory
A3. Private Practice 
A4. Reference Laboratory
Academic:
B1. Junior or Community College  B2. Undergraduate College or University 
B3. Graduate College or University
B4. Professional School 
B5. Non-Profit Research
Industry:
C1. Pharmaceuticals/ Chemicals
C2. Medical Diagnostics
C3. Agriculture/ Veterinary
C4. Biotechnology
C5. Food Products
Government:
D1. Federal  D2. State 
D3. Local

Links to Other Pages:

General Information
Scientific Program

Registration Form
This is not an interactive form. Please print the page, complete, and fax or mail.

_____________________________________________________________
Name
_____________________________________________________________
Organization/Institution
_____________________________________________________________
Department
_____________________________________________________________
Address
_____________________________________________________________
City                                            State                      Zip                Country
_____________________________________________________________
Business Telephone                                              Fax Number
_____________________________________________________________
E-mail Address                                                    ASM Member Number

Registration Category:                 Pregistration Deadline: September 1, 2001.
*After the preregistration deadline, fees will increase by $100 per category,
or $50 per student category.

Registration fee includes 4 breakfasts, 3 lunches, 2 receptions, 1 dinner
banquet, coffee breaks, and all program materials and supplies.
___ ASM/SGM Member (govt/univ) $495     ___ Nonmember (govt/univ) $595

___ Industry ASM/SGM Member $645         ___ Industry Nonmember $745      

___ ASM/SGM Member Student $295          ___ Nonmember Student $345
         (Predoctoral)*                                                  (Predoctoral)*
*Students must include a legible photocopy of a university ID validated
for Fall 2001 as proof of their predoctoral status.

Join ASM and Receive the Member Rate
If current ASM membership cannot be verified when registration forms
are received, the non-member rate will be charged automatically. Non-members
can join ASM when they register and receive the lower rate. To do so, please
download a membership application and submit it with your registration form to
ASM Conferences.

Membership Application

____ Yes! Register me at the ASM Member rate. My membership
application is attached. (Separate payment must be included).

Payment (must accompany this form):
    Total amount included (U.S. Dollars only): $ _______

Method of Payment (check one):
____ Check or money order enclosed (Payable to ASM Conferences).
____ VISA          ____ MasterCard            ____ American Express
         Sorry, we can not accept purchase orders or wire transfers.

__________________________________________________________
Card Number                                                              Expiration Date
_________________________________     
Name as it appears on card                                                 
__________________________________________________________
Signature                                                                                  Date

Mail OR Fax this form to:
Registration
ASM Conferences
1752 N Street, NW
Washington, DC 20036
Fax: 202/942-9340

Cancellation Policy:
All registration cancellations must be in writing and received by ASM
no later than September 14, 2001. A $50 administrative fee will be assessed
for cancellations received by September 14, 2001. No refunds will be
granted after that date.