STEM-Trek HPCKP19 Registration & Lodging Package

Question Title

* 1. Who are you?

Name

University

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Why would you like to attend HPCKP19?

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* 3. How would you pay-it-forward if you received free lodging and registration to attend HPCKP19?

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* 4. Please submit your feedback by April 24; award notifications will be sent by April 30.

Date / Time

Date

Time

AM/PM

Your information will not be shared with third-parties and will be deleted after 18 months.