East-to-West Iron Club 2017 | Registration Question Title * 1. Please provide your name, affiliation, and contact information.Registration is free. Name Institution Email Address Phone Number Question Title * 2. Please indicate your current position. Student Postdoctoral or clinical fellow Faculty Intramural investigator (NIH / CDC etc) Other professional Question Title * 3. Will you present a poster at EWIC?No abstract submission. You are welcome to present a new poster or recycle one presented at a recent conference. Yes No Question Title * 4. Please enter your poster information. (Please do not enter an abstract.) First author (if different) Poster title Question Title * 5. Students and postdocs only: Would you like to present at the Trainee Data Blitz? The Trainee Data Blitz (Wednesday afternoon) provides students and postdocs the opportunity to present a brief resumé of their poster—2 slides, 2 minutes, 2 questions. More details will be provided to those trainees who choose to participate. Space is limited to the first 12 respondents. Sign me up to present at the Trainee Data Blitz No thanks Question Title * 6. Will you join us for dinner Wednesday, October 25?Dinner 7:15 pm at Postmark Restaurant, 3410 Telford Street, Cincinnati, OH 45220 | Tel: (513) 281-3663Faculty/staff/guests: $45 per person not including beverages, gratuity, or tax. Students/postdocs: $15 per person not including beverages, gratuity, or tax.Please sign up soon to avoid disappointment! I will attend dinner I will attend dinner plus 1 guest I will not attend dinner Question Title * 7. Will you join us for lunch Thursday, October 26 (provided by EWIC/University of Cincnnati)? Yes No Question Title * 8. Do you have topic suggestions for the roundtable discussions? Question Title * 9. Would you be willing to facilitate / co-facilitate a roundtable discussion session? Yes No thanks Done