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First name
Last name
Email address
Title
Affiliation
Degrees
Preferred Pronouns
Relationship to PRC
CAB Representative
CDC PRC Program Staff
CDC SIP Sponsor
Community Member
Partner Organization
PRC Staff
Student
Contractor Staff (e.g., event planners, AV techs, webmaster, etc.)
Other
Participation
Virtual
In-Person
Are you submitting a poster for the conference website?
Yes, I am submitting for the website and will be presenting the poster in person during the conference.
Yes, I am submitting a poster, but I will not be there in person to present it.
No, I will not be submitting a poster at all.
I don't know. Please send me the poster instructions and information, just in case.
Will you be joining us for the group lunch January 15th? (Each individual must pay $29.50 for the lunch--the conference cannot pay for food.)
Yes, I will pay $29.50 to participate in the group buffet lunch on January 15th.
No, I will not be joining the group for lunch January 15th.
Please let us know of any requests for special accommodations for accessibility (e.g., ASL interpreters, captioning, etc.).
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