Registration

Your Contact Info

First Name or Initial: (Required)

Sorry Registration is closed

Middle Name(s) or Initial(s):

Last Name: (Required)

Public

Suffix:

e.g., Jr or PhD

E-mail: (Required)

jqpublic@microbeam.state.edu

Affiliation:

State University

Department:

Department of Microbeam Analysis

Mailing Address - 1: (Required)

Science and Engineering Building

Mailing Address - 2:

1 Quantitative Road

City: (Required)

Anytown

State:

Zip Code: (Required)

01234-5678

Country: (Required)

USA

Primary Telephone: (Required)

+1 234 567 8901

Alternative Telephone:

+1 987 654 3210

Fax:

+1 234 567 8900

Non-US Citizens

Additional Information is required to get you onto the NIST campus. Please fill out the information requested below. Us Citizens may skip this section entirely.

US Permanent Resident

Green Card Holder - must present to gain access - skip other fields in this section

All of the fields in this section are required for non-US citizens. Failure to provide all of the information or correct information may result in an attendee not being granted access to the NIST campus where the workshop is being held. Registration will close on September 23, 2011 - no exceptions!

Citizenship

If dual list both

Country of Residence

Title/Position

Date of Birth

MM//DD/YYYY

City and Country of Birth

Sydney, Australia

Passport Number

This must match the document you present for access to the NIST campus.

Passport Issuing Country

Australia

Gender

Male
Female

Employer

University of New South Wales

Dates Attending

I plan to attend on the following days:

October 24 (Required)

Evening reception only

October 25 (Required)

October 26 (Required)

October 27 (Required)

October 28 (Required)

Conference is over

Payment Info

I will submit payment for the conference via: (Required)

PayPal option (preferred) accepts PayPal login or credit card info. The registration fee is $375 for non-MAS/AMAS member professionals, $300 for MAS/AMAS member professionals, $150 for undergraduate and graduate students.

PayPal / Credit Card
Personal Check or vendor representative

Captcha Challenge (Required)

Please enter the characters into the field below as it helps to eliminate fraudulent submissions.

Sections

Personal tools

All of the fields in this section are required for non-US citizens. Failure to provide all of the information or correct information may result in an attendee not being granted access to the NIST campus where the workshop is being held. Registration will close on September 23, 2011 - no exceptions!