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2021 New Jersey Site Remediation Conference TECHNICAL TALK ABSTRACT SUBMITTAL Submit your Poster Proposal via email with the subject line “NJSRC 2021 Abstract Submission – last name” to [email protected] . Please submit as a .doc file. Deadline for submission: Monday, November 2, 2020, noon ENTER 1st PRESENTER INFORMATION BELOW Last Name Click or tap here to enter text. First Name Click or tap here to enter text. Middle Initial Click or tap here to enter text. Company Click or tap here to enter text. Title Click or tap here to enter text. Credentials Click or tap here to enter text. e-mail Click or tap here to enter text. Phone Click or tap here to entser text. Check if LSRPA member Check if Student If you are a student, please provide the following information School Click or tap here to enter text. Department Click or tap here to enter text. Type of degree Click or tap here to enter text. ENTER 2nd PRESENTER INFORMATION BELOW (leave blank if not applicable) Last Name Click or tap here to enter text. First Name Click or tap here to enter text. Middle Initial Click or tap here to enter text. Company Click or tap here to enter text. Title Click or tap here to enter text. Credentials Click or tap here to enter text. e-mail Click or tap here to enter text. Phone Click or tap here to entser text. Check if LSRPA member Check if Student If you are a student, please provide the following information School Click or tap here to enter text. Department Click or tap here to enter text. Page | 1

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2021 New Jersey Site Remediation Conference

TECHNICAL TALK ABSTRACT SUBMITTAL

Submit your Poster Proposal via email with the subject line “NJSRC 2021 Abstract Submission – last name” to [email protected]. Please submit as a .doc file.

Deadline for submission: Monday, November 2, 2020, noon

ENTER 1st PRESENTER INFORMATION BELOW

Last NameClick or tap here to enter text.

First NameClick or tap here to enter text.

Middle InitialClick or tap here to enter text.

CompanyClick or tap here to enter text.

TitleClick or tap here to enter text.

CredentialsClick or tap here to enter text.

e-mailClick or tap here to enter text.

PhoneClick or tap here to entser text.

Check if LSRPA member☐

Check if Student☐

If you are a student, please provide the following information

SchoolClick or tap here to enter text.

DepartmentClick or tap here to enter text.

Type of degreeClick or tap here to enter text.

ENTER 2nd PRESENTER INFORMATION BELOW (leave blank if not applicable)

Last NameClick or tap here to enter text.

First NameClick or tap here to enter text.

Middle InitialClick or tap here to enter text.

CompanyClick or tap here to enter text.

TitleClick or tap here to enter text.

CredentialsClick or tap here to enter text.

e-mailClick or tap here to enter text.

PhoneClick or tap here to entser text.

Check if LSRPA member☐

Check if Student☐

If you are a student, please provide the following information

SchoolClick or tap here to enter text.

DepartmentClick or tap here to enter text.

Academic AdvisorClick or tap here to enter text.

Type of degreeClick or tap here to enter text.

Add any additional author names in the box below

Attach RESUME for presenting author and one alternate (if more than one authors)

ENTER ABSTRACT INFORMATION BELOW

Type abstract information in the spaces below. Text boxes accept carriage returns.

SELECT THE CATEGORY that best describes the subject of the presentation

Choose an item.

TITLE Click or tap here to enter text. (200 characters limit)

ABSTRACT (Limit 2000 characters including discussion of presentation objectives, approach/activities, and results/conclusions).

Click or tap here to enter text.

Background/Relevance to LSRPs and Site Remediation

Click or tap here to enter text.

Timed Outline (must add to 30 minutes)

Duration (minutes)

Content Outline

5

Discussion

The NJSRC will apply for LSRP continuing education credit (0.5 CEU) for this presentation, if accepted.

If the abstract, relevance, timed agenda and resume are not all included, the Abstract will not be reviewed and considered.

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