2004 Rustbelt RNA Meeting Online Registration
Case Western Reserve University
Items marked with an * are required.
The conference registration fee is $40 (or $55 if Friday lunch is selected) for all attendees payable by check or money-order
only. Payment must be received by November 8, 2004. Please specify the names of all attendees covered by the payment
in a cover letter. Make the check or money order payble to:
Case Western Reserve University - Rustbelt Conference
c/o Dr. Mark G. Caprara
SOM-W106
10900 Euclid Ave.
Cleveland, OH 44106-4973
General Information
*First name:
*Last name:
*Full e-mail address:
*Department:
Address:
Address2:
Address3:
City:
State:
Zipcode:
Phone:
Fax:
*Gender
:
Male
Female
*Registrant status
:
PI
Trainee
Presentation Information
*Preferred type of presentation
:
not presenting
oral presentation
poster
Abstract title:
Presenter:
Department and institution:
Author 2:
Department and institution:
Author 3:
Department and institution:
Author 4:
Department and institution:
Please enter the email address of the PI:
Please enter the abstract text here. Note: Only plain text can be processed properly! Please do not use any special
characters. For example, for Greek letters use alpha, beta, etc., use degrees for temperature.
Please limit the total length of the abstract and references to 300 words or less.
Please enter any references here:
Abstract Keywords:
Food
*Meal preferences:
omnivorous
vegetarian
*A box lunch is available on Friday for $15.00. Would you like to reserve one?
Yes
No
Lodging
PIs Only
: PIs are responsible for booking their own rooms with the Deer Creek Lodge. call 1-877-678-3337 for reservations and refer to
Rustbelt
and account 60505W. The cost for one night will be ~$108.00
Trainees only
: Indicate your preference for room reservations (there is no extra charge for the room)
*Room type preference:
Double
Loft
Bunk
Name of preferred roommate (if any):
Roommates will be assigned by the conference (honoring preferences whenever possible).
Pressing the submit button will process your registration and generate a confirmation number with payment due.
Please print this for your receipt.
System designed by
Mark F. Beno
(8/2004)
System designed by Mark F. Beno (8/2004)