2015 Biochemistry and Computational & Molecular Biophysics Retreat

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October 23 & 24, 2015
Cedar Creek Conference Center
New Haven, MO
Space is limited and given on a first come, first serve basis!

Registration Deadline: Wednesday, September 23, 2015

Name *

University Position *

Faculty

Student

Postdoc

Research Personnel

Other

Gender *

Female

Male

Email Address *

Lab/PI Affiliation *

Graduate Program Affiliation (i.e., Biochemistry, CMBP, Chemistry, etc...) *

Attendance *

***The Retreat begins at 1pm on Friday, October 23 and ends 12pm on Saturday, October 24***

Attending Both Days (Room needed. Please note: Single rooms are limited and will be given on a first come, first serve basis.)

Friday Activities only (NO Room Needed)

Saturday Activities only (NO Room Needed)

Please Indicate your Roommate Preference *

Rooms will be shared. When possible, requests for a specific roommate will be honored. If you do not select a roommate, one will be assigned to you. Please make sure your roommate lists your name on his/her form.

Do you have any Dietary Restrictions (i.e., vegetarian, gluten free, etc...)?

Will you be Presenting a Poster? *

Students in their 3rd year and higher are highly encouraged to present a poster if they have not been selected to present a retreat talk.

Yes

If Yes, Please Enter Poster Title Below:

If you do not have a title right now, please email it to krussela@wusm.wustl.edu no later than Monday, October 12.

Would you Like a Retreat T-Shirt?

Please check the appropriate size. One T-shirt per attendee.

Small

Medium

Large

X-Large

XX-Large

For those Planning to Spend the Night:

If you are planning to stay overnight and need a room, the Department of Biochemistry and Molecular Biophysics and contributing Departments will cover the cost of the room on the condition that you attend the ENTIRE retreat. Full attendance is of particular importance to both donors and those presenting. If you book a room but don't attend the entire retreat or are a no show, the Program will bill you for a cancellation fee of $125. We would appreciate a 72 hour cancellation notification so those that are on a wait list can be accommodated.

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