| Salutation * |
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| First Name * |
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| Last Name * |
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| Nickname (for Badge) |
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| Degree |
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| Title/Position |
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| Department |
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| Organization * |
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| Street Address Line 1 * |
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| Street Address Line 2 |
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| City * |
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| State/Province * |
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| Country * |
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| Zip/Postal Code * |
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| Phone (Office) * |
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| Phone (Mobile) |
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| For Gala Dinner * |
Beef
Fish
No Preference |
| Special Diet |
Vegetarian
Kosher
No Preference |
| Special Diet Details |
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| Conference Choice - Rates * |
Non-Profit/Academic Rate @ $650 (Includes 3 day seminar, 3 lunches, 2 receptions and gala dinner) |
Standard/Corporate Rate @ $850 (Includes 3 day seminar, 3 lunches, 2 receptions and gala dinner) |
Developing Country Rate @ $375 (Includes 3 day seminar, 3 lunches, 2 receptions and gala dinner) |
Trainee Rate (Student, post-Doc, Fellow) @ $375 (Includes 3 day seminar, 3 lunches, 2 receptions and gala dinner) |
| Lunch Friday, June 20 * |
Yes No, I will not be attending the lunch |
| Lunch Saturday, June 21 * |
Yes No, I will not be attending the lunch |
| Lunch Sunday, June 22 * |
Yes No, I will not be attending the lunch |
| Dinner and entertainment at La Tasca (Spanish tapas restaurant): $35 * |
Yes No |
| Accompanying Person @ $35 * |
Yes No |
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Satellite Conference - extra day $125 * (Includes dinner Sunday and lunch Monday) |
Yes
No |
| Email Address * |
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| Password * |
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| Confirm Password * |
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| Password Hint * |
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If you know a colleague who may be interested in attending this conference as well,
please type his/her email address
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Comments or suggestions for the Program Committee
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*Indicates Required Fields
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