The symposium will focus on Current Avenues to a Cure/Eradication, Clinical Disease and Comorbidities and HIV Prevention.

December 8th & 9th 2014

Hosted by the Einstein-Montefiore CFAR & Women’s Interagency HIV Study Bronx, NY

Radisson Hotel
1 Radisson Plaza New Rochelle, NY 10801

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* 1. First Name:

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* 2. Last Name:

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* 3. Degree

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* 4. Title

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* 5. University/Organization

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* 6. Department

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* 7. Address Line 1

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* 8. Address Line 2

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* 9. City

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* 10. State

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* 11. Zip Code

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* 12. Country

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* 13. Daytime Phone/Extension

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* 14. Alternate Phone

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* 15. Email

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* 16. Will you be requiring a special dietary meal? (e.g. Kosher, vegetarian, other)

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* 17. Will you need any additional accommodations? If so, please provide detail below.

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* 18. Will you be making room reservations at the Radisson Hotel?

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* 19. Will you be submitting an abstract?

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* 20. Are you requesting a travel stipend?

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