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Registration Form

Registration Form

REGISTRATION FORM

UIS Science Research Symposium

—  Application Deadline April 1, 2008 —

Name of Presenter:
________________________________________________

TYPE OF PRESENTER:   ___Student   ____Faculty        ____Staff

Proposed title: _______________________________________________________

_________________________________________________

_________________________________________________

Type of presentation:   ____Poster         ____Oral

Has abstract been submitted electronically?  ____Yes      ____No

Home mailing address of presenter:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________

Phone: home _________________  work _____________________

Email: _________________________________________________

Please indicate if you have any specific equipment requirements:  (poster boards will be provided):

___ 35 mm slide projector

___ Overhead projector

___ Video

___ PC projection system

___ Other (explain)

Have you included a $10.00 Registration Fee?   ___Yes        ___No

Please make checks payable to UIS (marked for: UIS Science Research Symposium) and mail to:

Jo Patterson

University of Illinois Springfield

Biology Department, HSB 223

One University Plaza

Springfield, IL 62703-5407

Abstracts and complete oral presentations should be submitted electronically to jpatt2@uis.edu

ORAL PRESENTATION FILES SHOULD BE MAILED BY APRIL 5, 2008.

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University of Illinois Springfield
One University Plaza
Springfield, Illinois 62703-5407
217-206-6600

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