SSCI Inc. Short Course Registration Form

If you are registering by mail or fax, please print this form, fill it out, and send it to SSCI. Thank you!

Check to indicate selected course	Course Title	Registration Fee
	Pharmaceutical Solids: Essential Knowledge and Advanced Concepts April 8-10 , 2008 / Arlington, Virginia Please register by March 17, 2008	$1,950 (USD)
	Pharmaceutical Solids: Essential Knowledge and Advanced Concepts April 23-25 , 2008 / Macclesfield, England Please register by March 31, 2008	£950 early reg. £1150 late reg. (British Pounds)
	Pharmaceutical Solids: Essential Knowledge and Advanced Concepts May 14-15 , 2007 / San Francisco, California Please register by April 7, 2008	$1,200 (USD)

Government employees should contact SSCI Inc. for information about discounted course fees.

Dr./Mr./Ms.
Company:
Address:
City:
State/Zip/Country:
Telephone:	Fax:
Method of payment for course fee (Please circle):            Check            PO            MasterCard            Visa            American Express            Discover
Credit card or purchase order number:                                                                                         Expiration date:
Signature: (required for credit card payment)

Terms
1. Cancellations after SSCI's close of registration will be handled on an individual basis.
2. No-shows will be charged the full fee.
3. SSCI Inc. reserves the right to modify the course without notice.
4. Participants are responsible for making their own lodging arrangements.

Contact Information:

SSCI Inc. Phone 765-463-0112 / 800-375-2179 Fax 765-463-4722 Email info@ssci-inc.com

For internal use only:

Date TC

CK Recd

Conf. Sent

Reg. No.