DIMACS Workshop Registration Form

A Field Guide to GenBank and NCBI Molecular Biology Resources

March 1 - 2, 2005

Please register by filling out the following blanks.

When finished and you have checked the correctness of information, press the "send" button at the bottom of the form.

Attendance is limited to the first 150 registrations.

This course is specifically designed to include two parts: a lecture followed by a single hands-on 
computer session. Please do not register for a computer session if you will not also be attending 
the lecture. 

Please select your first, second, and third choice for the computer
session. Every attempt will be made to accomodate your preferences, but we cannot guarantee it.
  1. First Choice:
  2. Second Choice:
  3. Third Choice:
If you have a Rutgers RCI, CLAM, EDEN, or PEGASUS computer account, please enter your user name (not the password). Rutgers Computer Username:
Your First Name: Your Middle Name: Your last Name:
Your Position: (Please select best choice with button.)
Your Postal Address: (This information will be used for nametags & mailing lists) Name of organization: (University or Company Name)
Organization Type: (Please select best choice with button.) Department: Street Address: City, State, Zip Code: Country:
Phone: Required Field Fax: E-Mail: Required Field Web page URL:
Comments: (i.e. dietary restrictions)

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