SMART SURFACES

SEMINAR REGISTRATION FORM

This seminar is at no cost to attendees. Please fill in the following information to register.

(Numbers may be limited, so it is important that we can contact you if any seminar is over-subscribed)

In which city will you be attending the seminar?

Melbourne	22 July 2010	Brisbane	Date to be advised
Adelaide	4 November 2010	Perth	3 September 2010

*First Name:		*Surname:
*Phone:		*E-mail:
Address:

* Mandatory fields

*Organisation:
Primary area of professional interest:
Relevant infrastructure at your organization:
Known infrastructure gaps for smart surface fabrication:

Are you interested in ongoing collaboration?	Yes	No
Do you wish to be part of our contacts database?	Yes	No
Submit online or email to polymers@crcp.com.au or fax to 03 9543 2167
For more information please contact:
E-mail: polymers@crcp.com.au
Phone: (03) 9518 0400