PQCSA logo

Registration form

Please be social and only register if you really intend to come. This event is free of charge but registration is mandatory as we need to plan for catering. Please register only if you intend to come. That said, we hope you come and have an interesting day.

First name and middle initials (if applicable):

Last name:

Affiliation (the text you want to have appear on your nametag along with your name):

The information above will be used for name tags.

Email address (not for publication):

I confirm that this is my email address, and I agree to receive email at this address about this event.

Comments (dietary restrictions, etc.):
We will try to accommodate allergies and dietariy restrictions.