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2013 Academic Summit Registration - Undergraduate Research


ALL PARTICIPANTS INCLUDING PRESENTERS MUST REGISTER. If attending, there is a registration fee of $60 for faculty/staff or $30 for students.
Contact Information
* First Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
* Phone:

Academic Information
* Institution:
Academic Major:
List the name(s) of your faculty mentor(s):

Attendance Information
Sessions: (Please select all sessions you will be attending.)
Role: (Check all that apply)

Undergraduate Research
Title of oral presentation, poster presentation, art work or performance piece:
Collaborators: (Provide name, email, university for each co-presneter)
Presentation Type:
Abstract:
Describe your presentation in 100 words or less. If you are submitting for art, list medium and dimensions. If you are submitting for the performance piece, describe performance (dance, voice, instrument, etc).
Certification:
As a presenter, I have communicated with all co-presenters and they have agreed to content. Further, we understand that each presenter must register.
Required fields denoted with *