LEARNMEM2023 SYMPOSIUM SUBMISSIONS

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LEARNMEM2023 Symposium Proposals

Tell us about the symposium organizer

First Name*

Last Name*

Email*

Select one from the following*

faculty graduate student postdoctoral fellow undergraduate student research staff

Institution*

Gender*

Male Female Non-binary Prefer not to disclose

Other: Other Value

Race/Ethnicity*

White/Caucasian Black/African American Asian/Pacific Islander Native American/American Indian Hispanic/Latino Prefer not to disclose

Other: Other Value

Do you have a physical, mental or emotional condition that causes serious difficulty with your daily activities?*

Yes No Prefer not to disclose

Symposium Details

Symposium Title* Characters remaining:

500/500

Symposium Description* Characters remaining:

2300/2300

The symposium description should highlight the main theme and summarize the contributions of each speaker. You may also use the description to comment on the diversity of speakers and perspectives.

Symposium Speakers

Symposia consist of 4 speakers. The symposium organizer may or may not be one of the speakers.

Symposium Speaker 1

1. First Name*

1. Last Name*

1. Email*

1. Select one from the following*

faculty graduate student postdoctoral fellow undergraduate student research staff

1. Gender*

Male Female Non-binary Prefer not to disclose

Other: Other Value

1. Race/Ethnicity*

White/Caucasian Black/African American Asian/Pacific Islander Native American/American Indian Hispanic/Latino Prefer not to disclose

Other: Other Value

1. Does this speaker have a physical, mental or emotional condition that causes serious difficulty with your daily activities?*

Yes No Prefer not to disclose

Symposium Speaker 2

2. First Name*

2. Last Name*

2. Email*

2. Select one from the following*

faculty graduate student postdoctoral fellow undergraduate student research staff

2. Gender*

Male Female Non-binary Prefer not to disclose

Other: Other Value

2. Race/Ethnicity*

White/Caucasian Black/African American Asian/Pacific Islander Native American/American Indian Hispanic/Latino Prefer not to disclose

Other: Other Value

2. Does this speaker have a physical, mental or emotional condition that causes serious difficulty with your daily activities?*

Yes No Prefer not to disclose

Symposium Speaker 3

3. First Name*

3. Last Name*

3. Email*

3. Select one from the following*

faculty graduate student postdoctoral fellow undergraduate student research staff

3. Gender*

Male Female Non-binary Prefer not to disclose

Other: Other Value

3. Race/Ethnicity*

White/Caucasian Black/African American Asian/Pacific Islander Native American/American Indian Hispanic/Latino Prefer not to disclose

Other: Other Value

3. Does this speaker have a physical, mental or emotional condition that causes serious difficulty with your daily activities?*

Yes No Prefer not to disclose

Symposium Speaker 4

4. First Name*

4. Last Name*

4. Email*

4. Select one from the following*

faculty graduate student postdoctoral fellow undergraduate student research staff

4. Gender*

Male Female Non-binary Prefer not to disclose

Other: Other Value

4. Race/Ethnicity*

White/Caucasian Black/African American Asian/Pacific Islander Native American/American Indian Hispanic/Latino Prefer not to disclose

Other: Other Value

4. Does this speaker have a physical, mental or emotional condition that causes serious difficulty with your daily activities?*

Yes No Prefer not to disclose