Faculty Registration

Instructions Please complete this form to register for the 2016 Active and Smart Matter: A New Frontier for Science and Engineering conference. If you are interested in applying for a travel grant to offset the cost of registration and travel, please fill out the "Junior Scientist Travel Grant".
Registration fee: $200.00 When you submit this form, you will automatically be redirected to the payment processing page. Each Registration must be accompanied by full payment. You will receive an additional confirmation after your payment has been processed.
Name *
Email *
Institution *
Institution Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone
Status *

If you wish to present a poster, please provide a title and abstract.

Title

Abstract

350 words or fewer

File Upload

REMINDER When you submit this form, you will automatically be redirected to the payment processing page. Each Registration must be accompanied by full payment You will receive a confirmation after your payment has been processed.

ReminderWhen you submit this form, you will automatically be redirected to the payment processing page. Payment must be received to be considered registered. You will receive a confirmation after your payment has been processed.
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2016 Active and Smart Matter