Personal Information

    Please fill the form using CAPITAL LETTERS

    Title * :
    Last Name * :
    First Name * :
    Middle Name :
    Position :
    Affiliation * :
    Email * :
    Postal Address* :
    Zip/Postal Code :
    Town/City * :
    State/Province :
    Country * :
    Phone :
    Fax:

    Conference Information

    Abstract/Paper #1 * :
    Title #1 : Authors #1 :
    (Authors names separated by 😉
    Abstract/Paper #2 :
    Title #2 : Authors #2 :
    (Authors names separated by 😉
    Abstract/Paper #3 :
    Title #3 : Authors #3 :
    (Authors names separated by 😉
    Would you be willing to Chair a Session or Act as a Discussant?* :
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    For which sessions would you be willing to serve as Chair or Discussant?* :
    (Hold control key to select more than one option)