The Twelfth Meeting of the IHRN

Page One

1. Contact Information

Prefix *This question is required.

First Name *This question is required.

Middle Initial

Last Name *This question is required.

Title

Affiliation

Academy Represented

Email Address *This question is required. This question requires a valid email address.

2. Please provide a brief biography: *This question is required.

3. Please upload a photo of yourself below.
Make sure to click "UPLOAD" or your file will not be received.

File: {{filename}} delete

4. I have already made my hotel reservations at the Holiday Inn Panama Canal (Ciudad del Saber, Clayton, Panama City Panama). Please make reservations immediately if you haven't already done so. Participants are responsible for arranging and paying for their own accommodations. Reservations can be made by email or phone.

5. Do you require a visa? (If yes, the National Secretariat for Science, Technology and Innovation of Panama will provide more information)

6. If you will be traveling with guests, please list their names and titles to ensure that they are invited to relevant events and the symposium.

Name

Title

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