Registration Form
Name
Your answer
Email Address
Your answer
Current Institutional Affiliation
Your answer
Year of PhD
Your answer
Current Position
Please give a brief summary of your research and its relevance to the topics of quadratic forms and modular forms.
Your answer
Would you like to contribute a talk?
Will you require funding?
If you answered "Yes" to the previous question, please give an estimate of your travel costs from your home institution to and from Wesleyan University. Be sure to include estimates for relevant ground transportation.
Your answer
Will you have a car on campus?
Which nights do you plan to stay in Middletown?
To help maximize the number of funded participants, would you be willing to share a room?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms