5th Annual UCLA Mitochondria Conference
Thursday, December 9th,2021 (2pm-9pm)

Friday, December 10th, 2021 (9am-9pm)

Saturday, December 11th, 2021 (9am-2pm)
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Email *
Name (Last, First) *
Affiliation (i.e. university name, company name) *
Current position *
Do you plan to submit an abstract? *
Please choose 3 topics you would like to further discuss during the symposium breakout sessions *
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Dietary Restrictions
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I acknowledge that UCLA Indoor/Outdoor Organized Event Protocols require masking indoors. *
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COVID 19 Clearance Certificate Policy *
UCLA COVID-19 Vaccine/Negative Test Verification Policy for Non-Affiliates
Per UCLA Indoor/Outdoor Organized Event Protocols, non-Affiliates (non-UCLA community members) attending an indoor or outdoor organized event must show proof of being fully vaccinated or provide proof of a negative COVID test within 72 hours of the event upon entry.

Fully vaccinated means 2 weeks after second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or 2 weeks after a single-dose vaccine, such as Johnson & Johnson's Janssen vaccine.  You are also considered fully vaccinated if you have finished the series of a COVID-19 vaccine that has been listed for emergency use by the World Health Organization (WHO).  

Per LACDPH Health Officer Order (rev. 9/17/21), both PCR and antigen tests are acceptable as part of the entry process.  The following are acceptable proof of a negative COVID-19 test result:

-a photo ID of the attendee, AND

-printed documentation from a test provider or lab, OR an email or text message displayed on a smart phone from the test provider or lab. The information MUST include: the person's name, the date the test was performed, the type of test performed, AND a clear indication that the result was negative.

-the test must be dated at least 72 hours prior to the event.
UCLA COVID-19 Vaccine/Negative Test Verification Policy *
Payment of Conference Fee
After completing the registration, please visit following website to pay conference fee of $200, which includes all meals, workshops, and receptions: https://commerce.cashnet.com/SYMPOSIUM
A copy of your responses will be emailed to the address you provided.
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