CUWIP 2022@Arizona registration form
If you are undergraduate students received acceptance email from APS, please DO NOT use this registration form.  Please register using the APS registration link provided in the acceptance email.
For other participants, please fill out the following form to register for the CUWiP2022 @ Arizona.  If certain questions do not apply to you, just enter N/A (if field required) or leave it blank.  Any question, please email cuwip@arizona.edu.
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Badge Name (First, Middle, Last) *
Casual Name (Nickname)
What are your Preferred pronouns (she/her/hers; he/him/his, they/them/their, etc.)?
Professional Title *
Required
Affiliation (institution)   *
Address (including city, state, zip code)
Phone Number *
Email *
Emergency Contact (Name, phone and/or email, relationship) *
Your citizenship/Visa Status *
choose either "US citizen/green card" or enter "country, Visa classification" in "other"
Will you be 18 or over at the start of the conference? *
Please list the name of a faculty contact at your university (if applies).
How do you plan to travel to CUWiP (car, plane, etc.)?
Will you be requesting travel funding from the conference?
Clear selection
If driving/commuting, do you need parking?
Clear selection
What will be your approximate arrival date?
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What will be your approximate departure date?
MM
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DD
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YYYY
Which nights will you need a hotel room? *
Do you request single occupancy?
For undergraduate student participants, a double occupancy room will be provided at no costs to students.  Single occupancy rooms are limited and the participants will be responsible for the extra cost of $50/night for single occupancy. For non-undergraduate participants, please indicate your lodging preference. The rate is $50/night for double occupancy and $100/night for single occupancy.   If you choose "Don't need hotel room in previous question", then choose "no" for this question.
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For double occupancy, do you have a roommate request?
You will usually be assigned a roommate. If you know someone who is attending the conference and would like to room together, please list here.  You can also list you roommate preference here.  We will do our best to accommodate.  
For double occupancy, with roommates of which gender(s) would you be comfortable?
Special Dietary Needs
Vegetarian, vegan, gluten free, other please describe.  We will do our best to accommodate dietary needs.
Please specify any medical or other issues.
Are you interested in presenting a poster about your research?
Are you interested in presenting an oral talk about your research?
Do you need any specific accommodations to participate in this event?
Is there anything else you would like the LOC to know, or do you have any remaining questions?
Do you give the local organizing committee (LOC) permission to print your name, institution, and email address for distribution to other participants?
Clear selection
Do you give permission for the LOC to share your email address with other participants from your institution for travel coordination?
Clear selection
Do you give permission for the LOC to share your email address with your department chair for travel coordination?
Clear selection
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