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TEST Registration Form from Salesforce

  • Attendee Information

    This is how your name will appear on your name badge.
  • Max. file size: 4 MB.
    The headshot and bio may be submitted at a later date.
  • Childcare

    We are looking into potential childcare options for the Forum. One potential option would be to provide childcare in New Haven. Another potential option would be funding to help pay for childcare-related costs necessary for you to attend this event. In order to help us research potential options, please answer the following questions:
  • Logistics

    We can accommodate extra nights for those traveling from outside the northeastern United States.
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Scientific Abstract

    Note: The organizing committee will notify you early next year if you have been selected for a poster or a talk.
    Note: we are planning to have senior faculty members participate as session moderators and/or give posters!
    You may select more than one category, or add your own below.
    We would like to get diverse representation from all 7 Kavli Institutes in Neuroscience and will be notifying you in mid-December if you have been selected.
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