Manitoba Materials Conference - Registration Form

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www.materials.umanitoba.ca

MMC is an annual event highlighting research in fields related to Materials Science and Technology. The day will include highlighting the progress throughout the institute, speakers from various expertise backgrounds, poster/presentation competition, and a networking reception to end the day.

Join us for a full and exciting day about Materials Science and Technology!

Please fill out the information below indicating your particiption in the event. Please indicate if you will attend the lunch and/or networking mixer with your dietary restrictions to ensure that the correct amount and variety of foods will be available for this event. By clicking the "Submit" button, your completed forms will be directed to Jolly Hipolito, Operations Coordinator. If this application is not compatible with your device, you may direct your information details to Jolly Hipolito, Jolly.Hipolito@umanitoba.ca.

If you wish to participate in the poster presentation competition, please indicate "yes" at the end in the next section to have the poster presentation application section available to you.

A photographer will be on-site to capture the full day event. Photos will become available online shortly after the end of the conference. Photos will be made available on the websites.

Please have your registration submitted in a timely fashion.

Registration closes: TBD
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Name:* This field is required.Enter first name and last name.
First name
Last name
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E-mail:* This field is required.Enter e-mail address.
example@example.com
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Institution or Business Name:* This field is required.Name of the institution you attend or the name of your business.
Institution or Business Name
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Faculty:(optional if not applicable)
Faculty
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Department:* This field is required.Department name of your business or institution
Department
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Please indicate the catered event(s) you wish to attend:* This field is required.Morning and afternoon snacks made available for all that attend. Choose whether you will participate in lunch and hors d'oeuvre made at the indicated times (free of charge).
Boxed Lunch (12:00 pm)
Networking Mixer (5:00 - 7:00 pm)
None (no boxed lunch, no networking mixer)
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Dietary Restrictions:* This field is required.We will try to accommodate for any diets and allergies.
Yes
No
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Dietary Restrictions Continued:If you chose yes to the previous section, please indicate what your dietary concerns are.
If yes, please indicate your dietary needs (ie: vegetarian, vegan, halal, allergies to ..., etc.)
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Photograph Consent and Waiver:* This field is required.Photograph Consent and Waiver (details) If "yes", I further consent to the use of these photographs for the purpose of promotional material in connection with the University, including for use of the University website and social media sites. I further waive any rights to claim royalties or any other form of compensation or interest arising from the University's use of the photographs for the above-stated purpose. I further waive all copyright and any other interest I may have in the photographs. Notice Regarding Collection, Use, and Disclosure of Personal Information by the University Your personal information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the University for the purpose of registering you for the Manitoba Materials Conference. Your personal information will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions regarding the collection of your personal information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2. I hereby give consent to the University of Manitoba (the "University") to take photographs of myself (the "photographs" at the Manitoba Materials Conference. Details below.
Yes
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Are you participating in the poster competition?* This field is required.Participation in poster presentation? Yes or no
Yes
No
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Program:* This field is required.
High school
Undergraduate
M. Sc.
Ph. D.
PDF
Researcher/Other
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Please Indicate the poster research relevance:* This field is required.Choose at least one
Composite Materials: Metallurgical, Non-Metallic, Structural, and Sustainable
Quantum and Extreme Materials: Discovery Science and Sensors
Materials that Mimic Biology and/or Support Natural Systems Under Environmental Stress
Energy Harnessing and Storage
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Poster Title:* This field is required.Enter title of your poster
For formulas and other special font requirements, make a comment in the comment box to describe how to re-format your text (ie: adding superscript to text)
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Advisor(s):* This field is required.Enter name of advisor(s) here
List advisor(s) by first and last name, separated by commas (ie: Jane Doe, John Doe)
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Co-Author(s):List co-authors
List co-authors by first name followed by last name, separated by commas for multiple co-authors (ie: Jane Doe, John Doe, ...)
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Abstract (maximum 250 words):* This field is required.Enter poster abstract; maximum 250 words
For formulas and other special font requirements, make a comment in the comment box to describe how to re-format your text (ie: adding superscript to text)
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Comments:List any comments necessary regarding any special text re-formatting, or any other conference related comments and questions
Place any comments here to provide instruction for formulas and special font requirements, as well as any other additional comments as needed.
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Registration forms due date TBD. Submitted forms will confirm appropriate food choices, dietary restrictions, and/or poster registrations.

After clicking submit, your form will be electronically sent to Jolly Hipolito. Any changes and amendments to your form can be directed to Jolly Hipolito; Jolly.Hipolito@umanitoba.ca.
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