Register for the 2021 NIPTE Research Conference – The National Institute for Pharmaceutical Technology & Education, Inc.

Name *

First

Last

Please enter your preferred names. If applicable, this is the name that will appear on conference materials.

Email *

Only one registration per email address.

Title(s) *

Please enter your title. If more than one, please separate by a comma.

Credentials

Please list your credentials, such as PhD, MD, etc. Not required.

Select your association *

STUDENTS: if your University is listed as a NIPTE member organization, please select NIPTE Member Organization as your association.

Organization / Company Name *

Please enter your employer, associated company or academic institution.

NIPTE Member Organization *

If your organization is not listed, please select a different association.

Role *

Faculty / junior Faculty
Postdoc
Student
Staff / other

Are you a scheduled conference speaker?

Yes
No

What is your presentation preference? *

Live
Pre-recorded

Presentation title *

Enter the title of your presentation (if you need to revise later, please contact the NIPTE office).

Do you want to present a virtual research poster?

Yes
No

If you are a student at a NIPTE Member Organization, you are eligible to present your research at the conference. Please see the presentation instructions before completing this form.

What is your preferred presentation date?

December 1
December 2

We will make every effort to assign your presentation to the specified date. See the website for more information about student presentations. Final presentations are due November 24. Registrants will receive additional information via email.

Research title *

Enter the proposed title for your research presentation (you will have the opportunity to adjust later if needed)

Research or presentation abstract / summary *

Click or drag a file to this area to upload.

Attach a PDF document with your research abstract or presentation summary.

Your biography *

Enter your short (500 words or less) biography.

Headshot

Click or drag a file to this area to upload.

Please upload a high quality image we can use in our conference materials. JPEG or PNG preferred.

Can you participate in a live Q&A following your pre-recorded presentation? *

Yes
No

Please let us know if we can include Q&A for your session.