2011 RISE Midsummer Conference Registration
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1. Registration Form RISE Midsummer Conference July 20-21, 2011
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1
. Personal Information
Personal Information
Last Name
First Name
Title
Institution/Affiliation
Department or Major
RISE/TDW Mentor (RISE Students only)
Email Address (NMSU preferred)
Phone Number:
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. Please check all that apply:
Please check all that apply:
Invited speaker
RISE Workshop leader
RISE mentor
RISE staff
RISE student
(non-RISE) student
RISE Advisory Board
RISE Mentor Graduate Committee
RISE Mentor Undergraduate Committee
(non-RISE) NMSU faculty
(non-RISE) NMSU staff
Community (non-NMSU affiliate)
none of the above
other (please explain below)
Other (please specify)
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3
. Please select which applies to you:
Please select which applies to you:
I am NOT a graduate (RTP) RISE student
I am a graduate RTP student and will present my research
I am a graduate RTP student away on research travel and cannot attend
Please provide details of your research travel.
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. STUDENTS ONLY. Please check all that apply:
STUDENTS ONLY. Please check all that apply:
RTP (RISE to the Postdoctorate) student
RISE graduate facilitator
RTD student
GDW student
CDW student
MPSW student
MARC student
BRIDGES student
CAMP student
AMP student
HHMI student
(non-RISE) NMSU graduate student
(non-RISE) NMSU undergraduate student
none of the above
other (please explain below)
Other (please specify)
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. Presenters: TITLE
Please provide a title. If more than one presentation, provide a title for each.
***Non-speakers: Enter N/A***
Presenters: TITLE Please provide a title. If more than one presentation, provide a title for each. ***Non-speakers: Enter N/A***
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. Presenters: ABSTRACT
Please provide a brief abstract of 100 words. If more than one presentation, provide an abstract for each.
***Note: Group presenters must provide an abstract and specify that it is a group presentation.***
***Non-speakers: Enter N/A***
Presenters: ABSTRACT Please provide a brief abstract of 100 words. If more than one presentation, provide an abstract for each. ***Note: Group presenters must provide an abstract and specify that it is a group presentation.*** ***Non-speakers: Enter N/A***
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. OPTIONAL. Please enter a brief 50 word bio for the Conference Program Booklet.
Enter N/A if you do not wish to provide a bio.
OPTIONAL. Please enter a brief 50 word bio for the Conference Program Booklet. Enter N/A if you do not wish to provide a bio.
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. DAY 1: Please select events that you will attend on WEDNESDAY July 20th.
NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all their designated events.
DAY 1: Please select events that you will attend on WEDNESDAY July 20th. NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all their designated events.
I will attend all events for students in my RISE group
Team Discovery Showcase I: MPSW & GDW (1pm)
RISE to the Doctorate Showcase (2pm)
Postdoctorate Showcase: Dr. Steve Ontiveros (2:45pm)
RISE Mentor Showcase I: Dr. Xu, Dr. Maio & Dr. J. Houston (3pm)
RISE to the Postdoctorate Leadership Panel: Ameliah Davis, Nabeeh Hasan & Brenda Nieto (4:15pm)
Closing Remarks: Certificate/Raffle (4:40pm)
I will NOT attend today's Conference
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. DAY 2: Please enter events that you will attend on THURSDAY July 21st.
NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all their designated events.
DAY 2: Please enter events that you will attend on THURSDAY July 21st. NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all their designated events.
I will attend all events for students in my RISE group
Poster AM session (8am)
Welcome (9:30am)
Team Discovery Workshop Showcase II: CDW (9:35am)
Leadership Keynote: Dr. Narcisa Zarate (10:15am)
INBRE Speakers: Dr. Williams & Dr. Heidarian-Raissy (11:15am)
Poster LUNCH session (12:15pm)
Team Discovery Workshop Showcase III: MPSW & GDW (1:30pm)
RISE to the Postdoctorate Showcase: Gloricelys Rivera (2pm)
RISE Mentor Showcase II: Dr. Ryan Ashley (2:30pm)
Leadership Keynote: Dr. Marco Diaz (3pm)
Poster RECEPTION Session (3:45pm)
Transitioning to a PhD: Vanessa Selwyn (4:30pm)
Closing Remarks Certificates/Raffle (4:45pm)
none of the above
Other (please specify)
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. All social events for the RISE Midsummer Conference will be held in the O'Donnell Hall Lobby/Atrium. Please select social events that you will attend.
NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all specified events as part of RISE appointed duties.
All social events for the RISE Midsummer Conference will be held in the O'Donnell Hall Lobby/Atrium. Please select social events that you will attend. NOTE: RISE RTD, GDW, MPSW, CDW and RTP students are required to attend all specified events as part of RISE appointed duties.
W, July 20th, 2:30pm Snack break
W, July 20th, 3:35pm Ice Cream Social
TH, July 21st, 8:00am Breakfast
TH, July 21st, 11:00am Coffee Break
TH, July 21st, 12:15pm Lunch
TH, July 21st, 2:45pm Snack break
TH, July 21st, 3:45pm Poster Reception
none of the above
Other (please specify)
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. Presenters
What format are you presenting?
**select all that apply
Presenters What format are you presenting? **select all that apply
Group Oral Presentation
Individual Oral Presentation
Poster Presentation
Panel Presentation
Not Presenting
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. Please enter special needs below.
Please enter special needs below.
food/dietary restrictions
access/accomodations
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. Date Online Registration Submitted to RISE
Please enter response as MM/DD/YYYY
MM
DD
YYYY
Example: July 3, 2009 should be entered as 07/03/2009
Date Online Registration Submitted to RISE Please enter response as MM/DD/YYYY Example: July 3, 2009 should be entered as 07/03/2009 Month
/
Day
/
Year
Please click "Done" to complete and submit this registration form.
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