Please note* = required field
Presenter
*Full Name (first, then last):
*Department:
*Campus (e.g. Tuscarawas, Stark, Kent):
*Choose which one describes your affiliation with Kent State:
*E-mail:
Phone:
Co-presenter (if applicable)
First and last name:
Their affiliation with Kent State:
Their full department name:
Second Co-presenter (if applicable)
First and last name:
Their affiliation with Kent State:
Their full department name:
If there are additional co-presenters, please enter their full names (first and last), their affiliation with the university, as well as their full department name in the comments section below.
Presentation details
*Title of the presentation:
*Name of the meeting at which the presentation was given:
*City and state where the meeting took place:
*Country where the meeting took place:
*Date of presentation (e.g. Feb. 20-25, 2010):
Additional information
Enter a summary for possible inclusion in eInside:
Please enter any relevant Web links for possible inclusion in eInside:
Additional comments: