Kernz08 Pre-registration Questionnaire

 Name:
Position:
Affiliation:
Address:

Email:
Phone:
Fax:

1. I plan to attend:    [  ]Yes  [  ]No  [  ]Maybe
   
2. Areas of research expertise/interest (tick which apply);

[  ]Theory [  ]Experiment [  ]Astrophysics [  ]Structure [  ]Reactions [  ]Other – specify:

3. I will need accommodation at the Millennium Hotel
      [  ]Yes [  ]No  [  ]Maybe
   Note: Conference Dates are Sun, Nov 30 (evening) – Friday, Dec 5 (1 pm).
   
4. I will bring: [  ] a companion, [  ](#) children
   
5. [  ] I would like to share a room with another participant

Preference, if any:                   [  ]Use sharing webpage to be set up later

6. I am interested in a half-day excursion during the conference: (select two if desired)

*     Steamer on Lake Wakitipu: [  ] Yes [  ] No [  ]Or Sun, Nov 30

*     Dart River Safaris:       [  ] Yes [  ] No [  ]Or Sun, Nov 30 - dartriversafaris.co.nz

*     Jet boat on Shotover River : [  ] Yes [  ] No [  ]Or Sun, Nov 30 - shotoverjet.co.nz

*     Wine Tour:     [  ] Yes [  ] No [  ]Or Sun, Nov 30 - appellationcentral.co.nz

*     Lord of the Rings Tour:           [  ] Yes [  ] No [  ]Or Sun, Nov 30 - lordoftheringstours.co.nz

*     Other – specify:
 

7. I plan to attend the conference dinner: [  ] Yes [  ] No [  ](#) people
    

8. I am interested in presenting a talk or poster: [  ]Yes  [  ]No

Preference: [  ]oral presentation [  ]poster

9. Preliminary title of the presentation and either a preliminary abstract or a brief (1-2 sentence) description of the topic:

 

 

10. I have the following additional suggestions for the workshop organization or speakers:

Pre-registration Questionnaire
Please return to Ian Thompson, questionnaire@kernz.org