Please press "Submit Form" only once when completed. Your form will be sent directly to the Chemistry Department and a confirmation email will be sent upon receipt of this form. Alternatively, print the form and fax to (269) 387-2909, or scan and email to .
If you have questions, please contact:
Robin Lenkart
Department of Chemistry
Western Michigan University
Kalamazoo, MI 49008-5413
(269) 387-2922