2017 Annual Program Review Registration

Please complete this form to register for the 2017 DOE CSGF Annual Program Review and related activities. Once submitted, you will receive an automated e-mail confirmation. Please contact us if you have any questions. Thank you!

Personal Information
How would you like your FIRST name to appear on your badge?
Valid e-mail address (confirmation will be sent to this address).
Emergency Contact
Who should we call in case of an emergency?
Supplementary Information
If you selected 'Other', please explain.
Planned Attendance

I will attend the following:

Monday, July 24
Tuesday, July 25
Wednesday, July 26
Thursday, July 27
Post-Event Programming: CSGF+1

DOE CSGF alumnus Jaydeep (Jay) Bardhan is organizing a meeting of fellows and alumni the afternoon of Thursday, July 27. Please check the box below to indicate your interest in attending this post-program review gathering and discussion at the Crystal Gateway Marriott. Note that the meeting will conclude in time for attendees to depart D.C. yet that day if desired.

Hotel Reservation

Please complete this section ONLY if you require a hotel reservation.

The Krell Institute has reserved a block of rooms for attendees at a special rate. To reserve a room within the Krell Institute block, check the box below and enter the requested information. Rooms will be guaranteed/direct billed to Krell's master account, however, guests will be asked to supply a credit card upon check in to cover incidentals.

What type of room would you like?

A special note for federal employees: A limited number of government rate rooms have been reserved. Federal government employees planning to pay for their own accommodations should contact us for more details.

Marriott Rewards members may opt to pay for their rooms and accumulate points for their stay. If a valid Marriott Rewards number is provided below, it will be submitted to the hotel and a credit card will be required at check-in. Lodging and incidental charges will be billed to the card and will earn Marriott Rewards points.

Special Needs

Let us know how we can assist you. Please be as specific as possible.

Do you have any special health needs?
Do you have any special dietary needs?
Do you have any special room needs?
Are there any other needs we should be aware of?
Presentation Information

Please complete this section ONLY if you are a presenter.

Krell recommends that you make use of the provided equipment since the presentations will be recorded, but if you have special requirements for your presentation and need to use your own, please indicate this below and provide more detail in the comments section.

Which presentation software will you need?

Does your presentation have audio?

Does your presentation have a movie? (Please provide the format and resolution of your movie in the comment box below.)

The Krell Institute will make audio and video of your presentation available on the Internet following the event, but only with your express permission. Can your presentation be released?

Are there special items needed for your presentation?
Additional Comments
CSGFDOE Office of ScienceNNSAKrell Institute