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Theobald Smith Society 2023 Fall Symposium Registration Form
Event Date: 27 October 2023
Event Time: Noon - 5pm
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Email
*
Your email
First Name
*
Your answer
Family Name
*
Your answer
Organizational Affiliation (your college, university, company, etc.)
*
Your answer
Organizational Department
Your answer
Organizational Address
*
Your answer
Career Stage
*
Undergraduate Student
Graduate Student
Post-doc
Faculty
Industry
Government
Other:
Will you be presenting a poster?
*
Yes
No
Maybe. I'm thinking about it....
Required
Do you have any dietary restrictions?
*
None
Vegetarian (no meat, cheese and eggs OK)
Vegan
Kosher
Gluten free
You must be a TSS member to attend. Undergraduate and graduate student memberships are only $5. Regular memberships are $25. Lifetime memberships are $200. The link to join is
https://www.njmicrobe.org/join
Are you a member of Theobald Smith Society?
*
Not yet, but as soon as I finish this form I will join!
Yes
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