Registration Form Registration Form First Name * Last Name * Role * FacultyStudentPostdocOther Role For other, enter role. Program * Select a programBiochemistry and Molecular Biophysics (BMB)Cell and Molecular Biology (CMB)Committee on Development, Regeneration and Stem Cell Biology (DRSB)Committee on Genetics, Genomics and Systems Biology (GGSB)Human Genetics (HGEN)Other Program Lab Advisor Name (First and Last) Your Email Address * The registration fee is $150. Children 5 years old & under can attend free. The registration fee can be paid with a combination of personal funds, training or research grants, and/or departmental funds. Personal checks should be submitted to Sue Levison, CLSC 1111. Fees must be paid no later than Friday September 29, 2023. Cancellations: Registrants who cancel prior to Friday September 22, 2023 will not be charged the registrations fee. After September 22, registrants who cancel will be required to pay the full registration fee. One day registration: Attendees who do not plan to stay overnight at the Q Center must email molbio@bsd.uchicago.edu to let us know. Registration deadline: Last day to register is Monday September 18, 2023. Account number or name of person to be charged Name of authorized signer on the account Additional attendees who will accompany you to the retreat Transportation I will take bus provided to and from the Q CenterI will take bus provided to the Q CenterI will take bus provided from the Q CenterI will use my own transportation Specify your dietary requirements. Enter n/a if none. If you plan to present a talk or poster, complete the Link to present a talk or poster and submit your abstract. This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit Related Links Biological Sciences Division UChicago Maps Directories Q Center
