CHEMSAF Registration Form


By filling in the following form you will provide the Department with valuable information about our graduates. Please check the button if you do not want this material posted on our database page. To post a correction to previous data, simply fill out a new form.

Last Name:
Other Name(s):
Last Name at Graduation (if different):
Mailing Address:
Address cont'd:
City: Parish (State):
Country: Mailing Code:
Email Address (if applicable):
Year of Graduation:
What is your highest degree?

In what field is your highest degree?

Graduate Institution:

In what area is your current employment?

List me on the Database Page?

No: Yes:

Thanks for your continued support.


CHEMSAF logoReturn to CHEMSAF Home Page
Created and maintained by Prof. Robert J. Lancashire,
The Department of Chemistry, University of the West Indies,
Mona Campus, Kingston 7, Jamaica,
Note however that you should send questions or comments about our database to Dr Novelette Sadler-McKnight.

Created March 1998. Last modified 11th Ocotber 2009.
URL http://wwwchem.uwimona.edu.jm/chemsaf/safform.html