1. The following information is required by our funding sources. Please provide the following information:

   
   First Name
   Last Name
   School Name
   Email

2. Choose one of the following:

   
   Freshman Sophomore Junior Senior Faculty Other

3. Would like a vegetarian lunch?

   
   -- Yes No

4. The following questions will help us with reporting to our funding sources. We appreciate

   your willingness to answer them.

   1. How would you identify yourself?

      -- African American Asian Caucasian Hispanic Native American Other

   2. What is your gender?

      -- Male Female



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The deadline for submitting talk abstracts has now passed. Please proceed to the Submit Form button below.

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5. Is your talk a joint presentation with another student?

   
   -- Yes No

6. Please enter the names of joint presenters:

   
   

7. Please enter your title in the space provided below.

   
   

8. Please enter your abstract.

   
   

9. If you are applying to give a talk, do you prefer to give a 15 or 20 minute talk?

   
   -- 15 minutes 20 minutes

10. Please choose a T-shirt size (student speakers only):

    
    -- S M L XL

11. Are you a member of Pi Mu Epsilon?

    
    -- Yes No

Thank you for registering! We'll see you on March 13, 2010 at Pepperdine University!!