Registration Form

Mid Atlantic Numerical Analysis Day

Friday, 3 November 2017
Temple University


First and middle name(s):

Last name(s):

Affiliation:

(as it should appear on your badge and abstract)

Email address:

Are you a member of at least one of the following races/ethnicities: Black or African American, Native American, Hispanic or Latino?
Yes   No   Do not wish to provide
(we are required to ask this for statistical purposes)

Year of (expected) PhD:

Name of PhD thesis advisor:

Email of PhD thesis advisor:

If you plan to attend without giving a talk or presenting a poster, then please proceed directly to submit.
If you would like to give a talk or present a poster, please continue to fill out this form. The deadline for the submission of abstracts is October 1, 2017.

Preferred type of contribution:

Talk
Poster
Attending only, without talk or poster

Note: Not every participant may be invited to give a talk. Preference will be given to first time participants. Every participant will have the opportunity to either give a talk or present a poster.

Title of talk/poster:

Abstract:


You will receive an answer of acceptance by mid October.