Registration Form – Sample
Student Research Conference Registration Form – Sample
***This is a sample of the fields and questions you will see in the actual registration form. Please DO NOT begin a registration form until you are ready to fully submit.***
General Information
First name
________________________________________________________________
Last name
________________________________________________________________
Email address
________________________________________________________________
Participant type
- Student Presenter
- Faculty mentor
- General guest
- Coordinating committee member
Institution
- University of Michigan-Flint
- Mott Community College
- Kettering University
Class status
Display This Question: If Participant type = Student Presenter
- Undergraduate student
- Graduate student
T-shirt size (student presenters only)
Display This Question: If Participant type = Student Presenter
- S
- M
- L
- XL
- 2XL
- 3XL
Presentation Information
Presentation title
________________________________________________________________
Presentation type
- Poster presentation
- Oral presentation
- Performance/demonstration
Presentation abstract
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Faculty advisor first name
________________________________________________________________
Faculty advisor last name
________________________________________________________________
Faculty advisor department
________________________________________________________________
Faculty advisor institution
- University of Michigan-Flint
- Mott Community College
- Kettering University
- Other (specify) __________________________________________________
Faculty advisor email address
________________________________________________________________
Additional Notes
***NOTE #1: After this, student presenters are allowed to submit the names, email addresses, and shirt sizes for each additional co-presenter.***
***NOTE #2: Student presenters are allowed to submit one other additional faculty advisor.***