FFT 2019: Registration Form

Please complete this form to register for the 2019 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)*
Student Status*
Student Non-Student
Attending
Thursday talks
Thursday dinner ** (Link to payment site on following page.)
Friday talks
Address
Phone
The following information is for grant reporting purposes
Sex
Male Female Prefer not to Respond
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

** Cost of dinner: Students $15, Non-students $25