2024 Annual Program Review Registration

Please complete this form to register for the 2024 DOE CSGF Annual Program Review and related activities. Once submitted, you will receive an automated e-mail confirmation. Please contact us if you have any questions.

Personal Information

First Name

Last Name

Badge Name

How would you like your FIRST name to appear on your badge?

Pronouns

Other

Which pronouns should we include on your badge?

Affiliation

E-Mail

Valid e-mail address (confirmation will be sent to this address).

Mobile Phone

Emergency Contact

Emergency Contact Name

Who should we call in case of an emergency?

Mobile Phone

Supplementary Information

Current Program Status:

Other Status

If you selected 'Other', please explain.

Planned Attendance

I will attend the following:

Monday, July 15

Lunch

DOE Laboratories' Showcase

Tuesday, July 16

Lunch

Fellows' Poster Session

Wednesday, July 17

Lunch

Fellows' Poster Session

Thursday, July 18

Lunch

Post-Event Programming: CSGF+1

DOE CSGF alumni Jaydeep (Jay) Bardhan and Casey Berger are organizing a meeting of fellows and alumni the afternoon of Thursday, July 18. Please check the box below to indicate your interest in attending this post-program review gathering and discussion. Note that the meeting will conclude in time for attendees to depart D.C. yet that day if desired.

I am interested in attending the Thursday, July 18 meeting. Please have the organizers contact me with details.

Dietary Accommodations

Let us know how we can assist you. Please be as specific as possible.

Presentation Information

Please complete this section ONLY if you are a presenter.

I am presenting.

Krell recommends that you make use of the provided equipment since the presentations will be recorded, but if you have special requirements for your presentation and need to use your own, please indicate this below and provide more details in the comments section.

Which presentation software will you need?

Does your presentation have audio?

YesNo

Does your presentation have a movie? (Please provide the format and resolution of your movie in the comment box below.)

YesNo

The Krell Institute will make audio and video of your presentation available online following the event, but only with your express permission. Can your presentation be released?

I certify that my presentation has been released for posting online. It contains no information that needs to be withheld from publication for reasons of national security, export control, patentability or other intellectual property concerns (including copyright concerns). I either have the authority to release the presentation or assure the Krell Institute that it has gone through the necessary clearance process at my institution.I am unsure whether my presentation will be able to be released for public viewing (presentation will be withheld until receipt of a signed release).I am filling this form out as a representative of the registrant, and cannot affirm this statement (presentation will be withheld until receipt of a signed release).My presentation may not be released for public viewing.

Presentation Comments

Are there special items needed for your presentation?

Additional Comments

Your Message: