Please complete the following registration if paying with UC funds. You must have JavaScript enabled to use this form. First Name * Last Name * Primary E-mail * Contact Number * Dietary Restrictions (i.e. gluten-free; vegetarian) Message to the coordinator/accessibility requirements I am interested in campus housing Yes No This does not guarantee your registration for on-campus housing, please visit our accommodations webpage: https://bic2019.ucmerced.edu/accommodations Name for use on name badge * (eg. Dr. Emily Jane) Title for use on name badge * (eg. Professor, Post Doc, Student, etc.) UC Affiliation UC Berkeley UC Davis UC Irvine UC Los Angeles UC Merced UC Riverside UC San Diego UC San Francisco UC Santa Barbara UC Santa Cruz Registration Type * Undergraduate Students - $190 Graduate Students - $230 Postdocs / Staff Researchers - $230 Faculty - $350 Staff - $350 I am interested in presenting a poster Yes No I am interested in being an exhibitor Yes No I will be attending the Mixer event Yes No Thursday, June 27th, 2019 6:30pm - 8:30pm Yablokoff-Wallace Dining Center I will be attending the Reception event Yes No Friday, June 28, 2019 7:30pm - 10pm Vista Ranch Are you interested in making an optional donation Yes No To make a donation, please visit https://securelb.imodules.com/s/1650/index.aspx?sid=1650&gid=1&pgid=474&dids=234&bledit=1 Fund Approver First Name (your name if self) * Fund Approver Last Name (your name if self) * Fund Approver Phone Number * Fund Approver E-mail (yours if self) * Intercampus Order/Charge (IOC) Form If you are able to complete the Intercampus Order/Charge (IOC) form, please access, complete, and upload the appropriate form: UC Merced funds: https://ucmerced.box.com/s/gzp0k5ubo5d15pgq3wt4keeqxmcqtnt3 All other UC funds: https://ucmerced.box.com/s/rivsfw56jrn3tmf5ilyj55i60o1m27vn Please note if you are the Fund Approver and are submitting an IOC form, your submission acts as the funding approval.Files must be less than 2 MB.Allowed file types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip. Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
