IP Conference Registration

Registration Information

Registration Type*

General Participant: Attending to learn about and discuss topics regarding IP.
Early Career Investigator: Applying for a travel grant and submitting an abstract to present at the conference.
Speaker: Received an invitation from the planning committee to present on a topic at the conference.

Name*

First Name Last Name Credentials

Institutional Affiliation*

Please include title, position, department, and institution name.

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Phone*

Email*

Briefly describe why you would like to participate in this conference.*

Dietary Restrictions (Check all that apply)*

Please specify dietary restriction.*

Would you like to submit an abstract for consideration to potentially be presented during the conference?*

Yes
No

If a slot becomes available, I would be interested in attending the conference virtually.

While we strongly encourage all attendees to attend in-person we understand that coming in person may not be obtainable for all who wish to participate.

Yes
No

I consent to the National Foundation for Ectodermal Dysplasias (NFED) using photographs and video recordings of me and hereby irrevocably grant the NFED the perpetual right to use my name and likeness as incorporated in any such photographs or video recordings. I agree that the NFED shall own all rights, title, and interest to such photographs and video recordings, and that the NFED may edit, modify, and distribute such photographs without limitation, and without compensation, further permission or notification from me. I hereby waive any inspection or approval of use. I also waive and release the NFED from any claims based upon invasion of privacy or right of publicity.*

Yes
No

Abstract Submission

Primary or Competing Author*

Please include name, title, position, department, and institution name.

All Other Authors*

Please include name, title, position, department, and institution name for each, if known.

Upload Your Abstract*

Abstracts are limited to a 350-word maximum in either Word or PDF formats under 1 MB in size.

Accepted file types: doc, docx, pdf, Max. file size: 1 MB.

Explain Your Early Career*

If not selected for the travel grant, I would still be interested in participating in this conference.*

Yes
No

Hotel Information

If you are selected for the travel grant, the NFED will reserve your room accommodations at the Embassy Suites by Hilton Charlotte Uptown. Please confirm your arrival and departure dates below so we can make your reservation for the nights needed.

The NFED will reserve your room accommodations at the Embassy Suites by Hilton Charlotte Uptown for the conference. Please confirm your arrival and departure dates below so we can make your reservation for the nights needed.

Fees for Extended Stay*

The NFED will pay for 2 nights (2/20 and 2/21) for domestic guests and 3 nights for our international guests, if needed. To avoid the possibility of having to change rooms, the NFED will master bill your complete stay. Therefore, if you need to extend your stay beyond the covered dates, the NFED will invoice you to cover the cost of the extra nights.

I understand and, if appropriate, agree to pay the invoiced amount for my extended stay.

Arrival Date

Departure Date

Headshots & Bios

Upload Your Headshot

The NFED will need headshots for conference materials. Headshots are limited to PNG, JPG, or PDF formats under 1 MB in size.

Accepted file types: png, jpg, jpeg, pdf, Max. file size: 1 MB.

Upload Your Bio

The NFED will need a short one-paragraph biography for conference materials. Bios are limited to Word and PDF formats under 1 MB in size.

Accepted file types: word, wordx, pdf, Max. file size: 1 MB.

Comments

This field is for validation purposes and should be left unchanged.