K-INBRE Symposium Registration Form

Announcing the 8th Annual
K-INBRE Symposium

Saturday, January 16, 2010
through
Sunday, January 17, 2010

InterContinental Hotel on the Plaza
in Kansas City, MO

Please complete the symposium registration. If you choose to submit an abstract for the oral or poster presentations, submission guidelines will be emailed along with your registration confirmation. If you have any question please contact Jan Lyon, jlyon@kumc.edu or Heiata Chapman, hchapman@kumc.edu.

Individuals who are eligible for financial support for this meeting are graduate or undergraduate students and Star Trainees who have worked on K-INBRE funded projects, and all K-INBRE funded investigators and Postdocs both past and present.

*Required Information

My Affiliation is: *

General Information

Full Name:

* (Last name, First name)

Position/Title:

University:

Email:

Telephone:

I would like to opt out of having the above information listed in the program booklet.

Name as it should appear on your ID badge:

Sweatshirt Size:

Meals:

Meals provided are as follows:

Please check those meals you will require:

Y	N	Meal
		Saturday Breakfast
		Saturday Lunch
		Saturday Dinner
		Sunday Breakfast
		Sunday Box Lunch

I request a vegetarian box lunch on Sunday afternoon. Please only take a vegetarian box lunch at the conference if you have selected this option. Your name will be on your lunch.

If you wish to have a guest join the conference for meals (one or all meals) a $60.00 charge will apply. Payment by check is due December 11, 2009 made payable to

KUMC Research Institute, Inc.

Send check to:
K-INBRE Administrative Office
University of Kansas Medical Center
MS 3050
3901 Rainbow Blvd.,
Kansas City, KS 66160

Please contact either Heiata Chapman hchapman@kumc.edu or Jan Lyon jlyon@kumc.edu if you have any questions.

I intend to bring a guest.
Guest Name:

Special Assistance:

If you require special assistance at the symposium please let us know so that we may accommodate you.

Abstract Submission:*

Deadline for Abstract Submission: December 1

All participants may submit an abstract for a poster presentation. The poster competition (sponsored by KansasBio) and the oral presentation competition (sponsored by KUMC) are limited to trainees. All trainees (graduate, undergraduate and postdoctoral fellows) from K-INBRE or COBRE programs are eligible to compete.

*Please check all that apply: All poster/oral presentations must be accompanied by an abstract.

I will not be submitting an abstract.
I would like to submit my abstract for the poster presentation only.
           Graduate
           Undergraduate
           Other; I would like to submit my abstract for consideration in the trainee oral presentation competition
Graduate Undergraduate
: If not selected for a trainee oral presentation I would still like to submit my abstract for the poster presentation session.

: *Important: All abstracts must be accompanied by a presenter.
Presenter's Name(s): If more than one person is presenting a poster include all presenter names.

IMPORTANT ABSTRACT SUBMISSION GUIDELINES:
You will be emailed a registration confirmation which will include abstract submission guidelines. Please verify the email address you listed above.If you do not receive this confirmation your registration may not have been received. Please contact jlyon@kumc.edu or hchapman@kumc.edu.