2023 SOARS Conference Registration Form
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Email *
Last Name *
First Name *
Phone Number *
Please include area code
Mailing Address:  Street Number/Apartment Number *
Certificates of Participation will be mailed to this address following the SOARS Conference.
Mailing Address:  City or Town *
Mailing Address:  State *
Mailing Address:  Zip Code *
Mentor's Last Name *
Please do NOT include first names or titles, such as Mrs. Ms., Mr. or Dr.
Title of Presentation (This title will appear in the SOARS   Program.) *
Will you be giving an oral presentation or a poster presentation? *
Special Requests *
If there is a special request, please describe that request.
I understand that pictures and video of my presentation may be taken/recorded and posted on the SOARS website.  (Please contact Dr. Iannuzzi with any questions at:  michele.iannuzzisucich@sunyorange.edu)
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A copy of your responses will be emailed to the address you provided.
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