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CSD 2012 Retreat Registration

Please submit this form no later than July 31st, 2012. Thank you!

First Name*
Last Name*
Email address:
Program Affiliation:
Lab (if applicable):
Your Position Title:*
I will attend the retreat*
I will present a poster (mandatory for students 2nd year and beyond if not giving a talk)
I wish to present a research talk, the title of which is:
I have arranged to share a room with:
I would like a single room (only faculty & those bringing family members may request single room)
I will NOT need a hotel room on Friday night
We will offer a lunch on Friday at 12:00 with the retreat beginning at 1:00. Will you attend this lunch (free for students, $25 for others)?*
I will be bringing family members:*
Comments

Important Note:

Beer will be provided courtesy of the CSD faculty. A cash bar will be available for any additional beverage purchases.

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