UPPDA postdoc Reg 5-18-10

* Last Name:

* First Name:

Campus Mailing Address:

* Building:

* Room:

* Status:

Postdoctoral associate

Postdoctoral scholar

Clinical fellow

Other :

* Length of postdoc position at Pitt:

* Email: (Only University assigned email addresses can be accepted)

* Phone:

* How did you hear about the event?

*Please select primary school and department from drop down list.

Arts and Sciences
Select Department:

Dental Medicine
Select Department:

Engineering
Select Department:

Health & Rehabilitation
Select Department:

Information Sciences
Select Department:

Medicine
Select Department:

Nursing
Select Department:

Pharmacy
Select Department:

Public Health
Select Department:

Other
If other please specify:

Indicate Name of Faculty Mentor:

* Last:

* First:

* Email:

Poster Information

* Title:

* Field of Research: (Select One)

Poster Abstract Format:

Microsoft Word Document
Font: Times Roman Size 12 - Single Spacing - One Inch Margins
Maximum Characters: 1800
1st line: Title
2nd line: Author(s)
3rd line: Affiliation(s)

Name your file: (Name of first author)_(title of abstract).doc
(Example: Smith_Research.doc)

* Upload Word file here:

Poster Format:

May not exceed 4 foot by 8 foot.

* Indicates Response Required