CNDR Annual Retreat
Registration Form

October 28, 2011
8:00am - 4:45pm
Biomedical Research Building 2/3 Auditorium
421 Curie Boulevard

Retreat and Poster Registration

To register to present a poster at the Poster Session, please download this Word Document, complete it and return it via email to macleon@mail.med.upenn.edu or fax it to 215-349-5909. The deadline to register to present a poster is October 24, 2011.

For those wishing to register to attend the Retreat and Poster Session, please complete the registration form below and submit your registration electronically. 

***You MUST provide a valid email address to register to attend and/or present a poster.

I/we will be attending I/we will be presenting a poster
Name:
Guest:
Guest:
Contact Information (to receive verification of registration):
Address:
City:
State:
Zip:
Phone:
Fax:
Email (REQUIRED):
Affiliation:
Attending lunch Vegetarian lunch requested
The Center for Neurodegenerative Disease Research will be taking photos at this event for use in materials and on the website. Please contact us if you have concerns or objections to being photographed.

For more information, please contact 215-662-4708 or 215-662-4474. Parking and Directions For directions to Biomedical Research Building or BRB 2/3, click here. Information on parking is provided at the above link. You can also access parking information at http://www.business-services.upenn.edu/parking/index.html.

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