GIGI-Next Workshop Registration

GIGI-Next Workshop Registration

First Name *
Last Name *
Affiliation *
Email *
How will you be attending? *
Will you be presenting? *
Talk Title *
Abstract *
Will you be presenting? *
** Poster option must be selected to apply for a travel grant.
Talk title *
Abstract *
Poster Title *
Poster Abstract *
Will you be applying for a travel grant? *
Must be a student or be within 5 years of PhD to apply for a travel grant.
TRAVEL GRANT APPLICATION
Personal Information:
Legal name as on ID *
Enter your full legal name as it appears on your ID. *required if applying for travel grant
Date of Birth *
Phone Number *
Travel Info:

Please provide us with as much information as possible.

Departure City:
City
Departing Date
Return City:
City
Return Date
Airline
if known
Known Traveler Number
if available
Frequent Flier Number
if available
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