Full Name: (required) (as it should be appeared in the certificate)

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Alternative cellphone / WhatsApp number: (optional, will not be displayed to public)

Category: (required) General Grad Student Undergrad Student (S1)

Contributed/Non-Contributed Speaker: (required) Contributed Speaker (will present a paper) Non-contributed Speaker (will not present a paper)

Presentation: (required for contributed speaker only) Live presentation Pre-recorded (video duration at most 7 minutes)

Address: (optional, will not be displayed to public)