FFT 2017: Registration Form

Please complete this form to register for the 2017 February Fourier Talks at the Norbert Wiener Center in the Department of Mathematics at the University of Maryland, College Park.

First name*
Last name*
Email address*
Retype email address*
Affiliation (Company or Institution)*
Attending
Thursday talks
Thursday dinner
Friday talks
Address
Phone
The following information is for grant reporting purposes
Sex*
Male Female
Race/ethnicity
(you may select more than one)
American Indian or Alaska Native
Hawaiian or other Pacific Islander
Asian or Asian American
Black or African American
Hispanic or Latino
Caucasian/White
Other

* = Required field!