IWC Presenting Author’s Information Form

Presenting Author Contact Information
Name
First Last Suffix
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (xxx-xxx-xxxx)
Author Email*
Paper Title*
75 Word Abstract - (Optional)
Number of Co-Authors (if any)*
- 0
- 1
- 2
- 3
- 4
Please fill out Co-Author Information
1st Co-Author Name
First Last Suffix
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (xxx-xxx-xxxx)
Email
2nd Co-Author Name
First Last Suffix
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (xxx-xxx-xxxx)
Email
3rd Co-Author Name
First Last Suffix
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (xxx-xxx-xxxx)
Email
4th Co-Author Name
First Last Suffix
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (xxx-xxx-xxxx)
Email

Engineers' Society of Western Pennsylvania