Registration Form — NEMPET

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Registration Form

Name *

First Name

Last Name

Pronouns

Email *

Position *

Undergrad

Grad

Postdoc

Faculty

Presentation Type *

Talk

Poster

None

Length of Talk

20 min

30 min

45 min

60 min

Title of Presentation

Authors

School *

Department *

Bldg./Road *

City *

State *

Zipcode *

Roommate Preferences/Gender

Room/Bldg. Preference

Dietary Restriction/Choices

Nametag Preferences *

Please enter your preferred name, pronouns and institution to be listed on your nametag.

Thank you!

Registration Rates:

Student- $550

Faculty/Other- $675

All registration fees include 5 entries into Door Prize drawings. Extra tickets can be purchased for $2 each.

NEMPET

32 North Shore Blvd
Helmetta, NJ 08828

phelps@envsci.rutgers.edu