Contact Information
Undergraduate Student Research
Competition
Submission
Please make sure your entry to the Competition is completed by
Friday, June 15th.
*
Please note - any groups of two or more submitting a presentation only need to make
one submission
for their group to be entered. Group members do not need to make separate submissions for each member. If you need to make a change to an abstract that has already been submitted, please send an email to tylerd@adha.net.
Program Details:
Takes place during ADHA's 2018 95th Annual Conference in Columbus, OH.
Wednesday, June 20 - 3:00 p.m. - 4:00 p.m.: Undergraduate Student Research Setup
Wednesday, June 20 - 4:00 p.m. - 6:00 p.m.: Judging
Thursday, June 21 - 12:00 p.m. - 1:00 p.m.: Awards Luncheon
Thursday, June 21 - 2:00 p.m. - 4:00 p.m.: Open viewing attended by presenters
Thursday, June 21 - 4:00 p.m.: Pick up presentations
How did you hear about the Undergraduate Student Research Competition?
*
Will you be presenting a RESEARCH POSTER or an INFORMATIVE POSTER PRESENTATION?
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Research Poster (A research poster is a presentation of an original research study. Posters incorporate visual media and original data that reflect an area of National Dental Hygiene Research Agenda)
Informative Poster Presentation (An informative poster presentation is a poster presentation using oral communication and visual media to inform, clarify, and/or review material on a specific topic. An informative poster presentation is NOT original research)
School Name:
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Presenter #1 First Name:
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Presenter #1 Last Name:
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Presenter #1 ADHA Member Number:
*
Address (Line 1):
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Address (Line 2):
City:
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State:
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
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Cell Phone:
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Email Address:
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Are there additional presenters?
*
Yes
No
Additional Presenters: List the names of the additional presenters below:
Additional Presenter #2: First Name
Additional Presenter #2: Last Name
Additional Presenter #2: ADHA Member Number
Additional Presenter #2: Email Address
Additional Presenter #3: First Name
Additional Presenter #3: Last Name
Additional Presenter #3: ADHA Member Number
Additional Presenter #3: Email Address
Additional Presenter #4: First Name
Additional Presenter #4: Last Name
Additional Presenter #4: ADHA Member Number
Additional Presenter #4: Email Address
Please indicate
one
presenter as the main contact who will receive correspondence from ADHA regarding payment and registration. The main contact can be any of the presenters listed.
Main Contact: First Name
Main Contact: Last Name
Main Contact: Email Address
Main Contact: Phone Number