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Registration: NMIN 2021 Trainee Symposium

Please complete the following form to register for NMIN’s 2021 Trainee Symposium.

You will be prompted to complete additional fields based on your replies to the field(s) presently visible.

Are you involved in an NMIN-sponsored project? *

Yes
No

Role/Position in NMIN project *

Trainee/HQP
Research staff
Other

Please specify your role/position *

PI of the NMIN project with which you are affiliated *

Please provide the full name of the Principle Investigator on the NMIN project with which you are affiliated

Are you a member of the NMIN HQP Network (NHN)? *

Yes
No

Enter "yes" if you have formally applied to and been accepted in the NHN.

Are you an NMIN New Professional? *

Yes
No

Enter "yes" if you have been formally designated this status within NMIN. Please note that your registration does not guarantee your attendance at this event; your inclusion will contingent upon available space. An NMIN staff member will contact you to confirm your status closer to the event date.

INELIGIBLE: Sorry, you are not eligible to register for the NMIN Trainee Symposium

If you are not working on an NMIN-sponsored project, nor have you applied to and been accepted as a member of the NMIN HQP Network (NHN), then you are not eligible to participate in this event. If you have questions about your eligibility, please contact leahgraystone@nanomedicines.ca or enter your comment in the field above.

Prefix

Ms.
Mrs.
Mr.
Dr.

Name *

First

Last

Email *

Cell *

Gender *

Female
Male
Other

Affiliation (Institution/Company) *

Discipline/Faculty/Department

Supervisor

City and province of residence (where you will be traveling from to attend this event) *

Do you have a food allergy? *

Yes
No

Food allergy details

Please list the food(s) to which you are allergic

Dietary needs

Vegetarian
Vegan
Other
I'll eat anything

If you have other dietary needs, please describe them

If you have other special needs or accessiblity issues, please describe them

Do you live in Toronto?

Yes, I live in Toronto
No, I do not in Toronto

Please provide your Toronto street address

People living in Toronto within a reasonable commute of the venue will not be eligible for NMIN-sponsored hotel rooms unless special circumstances apply. Please select the option that applies you:

Although I live in Toronto, my commute to the event venue would be too long
Special circumstances apply to me
I can commute to the event venue

If you indicate that your commute is too long, an NMIN staff member will be in contact to confirm whether or not you are eligible for an NMIN-sponsored hotel room.

Please provide details about the special circumstances that apply to you

Thank you for explaining your circumstances. An NMIN staff member will be in contact to confirm whether or not you are eligible for an NMIN-sponsored hotel room.

Do you need accommodation at the venue (Omni King Edward Hotel)? (copy)

Yes, I need a hotel room at the venue
No, I have another place to stay

For which nights do you require a room? (Check all that apply)

November 17 (covered by NMIN if you meet the criteria)
Additional days (at your own expense)

If you attend 100% of the Symposium sessions, NMIN will cover your accommodation costs the night of Nov 17.

For which additional day(s) do you require a hotel room (at your own expense)?

NMIN will reserve your room for the days requested but you will be billed for these additional days.

Checkboxes *

I consent to and agree that NMIN may use my image, name, and a summary of my expertise in print and electronic communications, including web-based platforms, in relation to my attendance at the Trainee Symposium.

To register, it is required that you agree to this statement by clicking the checkbox.

Checkboxes (copy) *

I understand that funding support will not be provided if I do not attend 100% - all sessions - of the Trainee Symposium.

To register, it is required that you agree to this statement by clicking the checkbox.

Checkboxes (copy) (copy) *

I understand this is an in-person only event; I agree to be fully vaccinated at the time of the event and I agree to wear a mask at all times during the event except while eating.

To register, it is required that you agree to this statement by clicking the checkbox.

If you have been vaccinated against COVID-19, please list the vaccine(s) recieved below, with the date.

Please upload a scan or PDF of any COVID-19 vaccination records you presently have.

Click or drag a file to this area to upload.

Proof of vaccination will be required for admission to this event. If you are unable to provide documentation as part of your registration, you must present it at the event to be admitted.

Would you like to receive email updates from NMIN about future events, opportunities and developments in the network?

Yes, please
No, thanks

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