Shrevefest

If you do not receive an email confirmation of your registration within a couple of days, or if you have other questions about registration, please contact Jim.Coykendall@gmail.com.

Last name:

First name:

Current university affiliation:

Email address:

Are you a graduate student? Yes No
Are you a postdoc? Yes No
Current position (for non-students):

Graduation date for PhD (expected or actual):

Dissertation/thesis advisor (for students):

Do you want to be considered for funding? Yes No
Estimated airfare or total round-trip mileage if driving (e.g., from mapquest.com)

Complete mailing address (including country, for reimbursment and other communication):

Are you a US citizen or permanent resident? (for funding purposes only)
US Citizen US Permanent Resident Neither
Visa type (if applicable):

Do you need help arranging for local accomodation? Yes No
Do you plan to attend the banquet on Friday, May 3? Yes No
Dietary restrictions?

Additional comments: