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Adresse personnelle

ou saisir le détail de l'adresse manuellement

Complément d'adresse (facultatif)

Code postal

Ville

Pays

État

Supprimer l'adresse et en saisir une nouvelle

Gender (Please specifiy)

Institute (specify town / country)

Abstract submission for posters and oral presentations sent by email - Deadline June 20th

I'am submitting an abstract, and I am applying for oral presentation (young researchers only)

I'am submitting an abstract, and I don't apply for oral presentation

No abstract

Would we like to do an oral presentation ?

Yes

Would you like to present a poster ?

Yes

Abstract [1 page max, 11pts Time New Roman, title, authors and affiliation, no figure]

Would you like to chair one of the symposium ? If yes specify which one

Astrocytes

Glial cell interactions

Microglia

Oligodendrocytes

Will you join us for our social event at the end of the meeting ?

Maybe

Yes

Specific Diet

Allergen-free

Gluten-free

None

Vegan

Vegetarian

If a specific diet in needed please specify

Do you accept usage of your image for our social media ?

Yes

Attestation from supervisor (Phd student, Post Doc)

Student certificate (Licence/Master Student)

For rooms with double occupancy, name of the person sharing the room (N/A if single occupancy):

Abstract submission, with registration or by email (glialcellclub@gmail.com), deadline July 18th

Yes & I apply for an oral presentation

Yes & I don't apply for an oral presentation

Will you take part in the meeting of the club des cellules gliales (8-11th Octobre, same venue)?

Yes

Current position:

Engineer/tech

PhD

Post-Doc

Date of appointment:

Research project, current expertise and how it fits with the workshop?

Ranking of the workshops (based on your interest for Imaging, metabolism or transcriptomics):

Recommendation letter from the PI

Stipend request

Yes

Institution (ajouter la ville et le pays)

Langue (français, Anglais, les deux)

Poste occupé actuellement:

Ingénieur(e)

PhD

Post-Doc

Technicien(ne)

Date du recrutement au poste actuel:

Projet de recherche actuel, expertise technique, que vous apporte ces ateliers?

Classez les ateliers par ordre de préférence (ex: 1 Imagerie, 2 métabolisme, 3 transcriptomique)

Lettre de motivation

Lettre de recommendation du superviseur

Demande de bourse

Non

Oui

Régime alimentaire

Pas de préférence

Sans allergènes

Sans gluten

Végétalien

Végétarien

Si allergènes connus précisez:

Droit à l'image (site web et réseaux sociaux)

Non

Oui

English skills

1 None (Do not understand and cannot speak)

2 Poor (Understand but cannot speak)

3 medium

4 Good

5 Expert

All rooms are shared (except Instructors). Roomate name if known / specification if needed ?

Inscription

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