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* Denotes required Fields
Submitter Information
* Submitter's First Name
* Submitter's Last Name
* Telephone (work)
(format: (613) 245-4589)
Position/Affiliation
Choose a position
Physicist-University
Physicist-National Lab
Physicist-Industry
Physicist-Retired
High School Teacher
Museum Employee
Physics Administrator
Physics Student
Other (please specify)
OR
(other)
* Email (Work)
Event Information
* Name of the event:
* Short description:
(2-3 sentences)
Type of Event:
Choose Type of Event
International
National
Regional
Local
Target Audience:
Choose Target Audience
Public
JK-12 Students
High School Students
Undergraduate Students
Graduate Students
All Students
High School Teachers
University Professors
All Teachers
Academic Physicists
Government Physicists
Research Lab Physicists
Industrial Physicists
All Physicists
Event web site: (format: http://www.cap.ca)
* Start date of the event:
format (mm/dd/yyyy)
If this is a one day event please state time:
Start Time:
(24:00)
End Time:
(24:00)
* End date of the event:
format (mm/dd/yyyy)
Province OR Country where event will be held:
Choose province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Nunavut
North West Territories
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
OR
(country)
* City where event will be held:
Building name:
* Street address:
Event Contact Information:
If same as
Submitter
information click here:
* Contact's first name:
* Contact's last name:
* Contact phone number
(format: (613) 245-4589)
* Contact email:
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