2019 Midwest Region Proposal Submission Form
Please list your contact information from now until the meeting. All correspondence for your proposal will be sent to the e-mail address you enter.
Email address *
Family name (surname or last name) *
Your answer
Given name (forename, first name, or personal name) *
Your answer
Full name as you want it to appear in the program (do not include titles, honorifics, or degrees, e.g., Dr. Prof., Ph.D., Rev.) *
Your answer
Institutional affiliation (please do not use abbreviations or acronyms for institutional names. If you are an independent scholar, please indicate your city and state.) *
Your answer
E-mail address (all correspondence for your proposal will be sent to the e-mail address you enter. Please double-check the address you enter.) *
Your answer
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