AMS Rochester 2017
Conference Buddy Registration

Conference Buddy Registration Form

* Denotes required fields

*First Name: 
*Last Name: 
*E-mail: 
Cell phone at meeting: 
*Institutional affiliation or city of residence: 

*Please select a participation level:   Mentee
 Paired mentee
    (2 mentees with 1 mentor)
To participate as a Mentor, you must first log-in

*Current academic level:   Undergraduate
 Masters student
 Ph.D. / DMA student
 Lecturer/Adjunct. Prof.
 Independent Scholar
 Asst. Prof.
 Assoc. Prof.
 Professor
 Librarian / archivist
 Other 

*Interests (25 or fewer words): 
(long entries will be truncated) 
Other information: 
(i.e.: arrival date, reason for attending, 
personal fact like "just published a book", etc.) 

  (clears form)          

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