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Name and Last Name
UID
Address
Phone
Email
College
Department
Name of faculty mentor or chair
Start day of the conference
Name of the conference
Conference webpage/website
Title of Presentation
Location of conference
Conference Registration Fee
Statement: Please discuss the value of your participation in this conference to your academic and professional advancement (150 words maximum).
Please submit here the acceptance letter from the conference organizers.
Drop files or click here to upload
Departments will reimburse the PCSA to the postdocs. Please provide the contact person who will handle the reimbursement: Business Officer Name and Email Address
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