Senior International Leaders' Meeting 2022

I will join:

In-person meeting at UC Riverside (Oct 17-19)

Virtual session on Oct 18 16:30-1800 (UTC-7 hrs)/Oct 19 07:30-0900 (UTC+8 hrs)

Title

Others, please specify

Name

First

Middle

Last

Full name as it will appear on name badge and in publications

University/Institution

Position/Designation

Primary email address

Other email address(es)

Email address to be listed in publications

Correspondence Address

City

State/Province

Zip/Postal

Country/Region

Phone number

Contact person in the event of emergency

Phone number of contact person

Do you require a visa to enter the US?

Yes (please contact [email protected] to request for a visa letter if needed)

No

Do you have any dietary requirements or special needs?

Which of the following activities do you plan to attend? (check all that apply)

Welcome Reception on 17 Oct evening

Lunch on 18 Oct afternoon

Networking Dinner on 18 Oct evening

Closing Lunch on 19 Oct afternoon

APWiL Mentoring Program 2nd Cohort Graduation Ceremony on 19 Oct evening (Americas)/20 Oct morning (Oceania & Asia)

Will you also join the APWiL Mentoring Program 2nd Cohort Graduation Ceremony on 19 Oct (1800-1930 UTC-7 hours)/0900-1030 (UTC+8 hours)(Thur, 20 Oct)?

Yes

No

To be decided

Estimated date of arriving in the US

The organiser is planing to provide group airport transfers from LAX to downtown Riverside on 17 Oct. Will you be interested to use this service?

Yes

No

To be confirmed

If yes, what is your estimated time of arrival in LAX on 17 Oct?

Is there any other information you would like to share with the organiser?