Annual Meeting Form
About The Institute Faculty & Research Education Industry / Partnership Program FIP Pioneer Award Events & Activities Directions Contact Us	Registration Fee is $40.00 All Duke FIP members registration is waived as this is a benefit for our members. Please complete all fields below before submitting your registration.  Due to the economy this year, we've cut back to a 1 day event.  Also, please note that the form shows 2 days for the Annual Meeting and we are unable to change the form at this time.  Please select ONLY DAY 1 to attend.  - Thanks. Prefix Dr. Mr. Mrs. Ms. Professor Other First Name Last Name Title CEO President VP Manager Other   If Other:  Company/University/Affiliation Duke University Faculty Duke University Student Duke University Postdoc/Research Associate/Scientist Other Affiliation:  Mailing Address Mailing Address 2 City/Province State Zip/Postal Code Country Email Address Registration for Annual Meeting/Symopsium Must select one box for Attendance:     Attend Day 1 Must select one box for Food Choice:     Vegetarian     Meat I would like to be added to the invitation list for annual meetings I would not like to be added to the invitation list for annual meetings I would like to be added to the Mailing List of FIP Broadband Newsletter I would not like to be added to the Mailing List of FIP Broadband Newsletter *Note: that this list is not shared with any other sources. Only used by the Fitzpatrick Institute for Photonics (FIP) for announcing annual events and semi-annual newsletters. Reload Image