REGISTRATION FORMSixteenth Annual Michigan Space Grant Consortium Fall Conference

REGISTRATION FORM

Sixteenth Annual Michigan Space Grant Consortium Fall Conference
Saturday, October 6, 2012

First and Last Name: *

***Title: *

***Faculty or Staff Title (Professor, Associate Professor, Research Scientist, etc.).
If you are a student, are you a graduate or undergraduate student?

Institution: *

If you chose "other institution" above, please list institution:

Department *

Address: *

Phone: *

Fax: *

Email Address: *

I plan to attend the entire conference and will require lunch:

I Require A Vegetarian Lunch:

If Vegetarian Lunch Requested:

		Dairy Okay
		No Dairy (Vegan)

I am not attending the entire conference and do not require lunch:

I will be making a presentation at the conference.
I have reviewed the sample abstract to use as a guide
while I prepare my conference abstract
(abstracts can be no longer than one page with Times Font/Size 12 with one-inch margins).
Note: Your Abstract MUST be submitted now. Please upload (below):

Upload Your Abstract (for those presenting):
Note: .DOC or .DOCX only

If you are presenting, which do you prefer?:

		A Lecture
		A Poster Presentation

Important Note: If you are selected to make a presentation, you must
bring a memory stick (which contains your presentation), for David McLean,
Conference Systems Administrator.

My Presentation Will Be On A (choose one):

		MAC
		PC

I Will:

		Bring My Own Laptop
		Use The Conference Provided Laptop