Registration for Affiliates Annual Meeting, April 23-24, 2009

To register for the 2009 Affiliates Annual Meeting please complete the form below, and then click the SUBMIT INFORMATION button. Items in red are required. Following submission, a confirmation of your application will be displayed. (Print a copy for your records.)

Travel expenses will be paid by NISS as part of your Affiliates membership benefits.

Participant Information

First Name Family Name

Organization

Address

City State Zip (or Postal) Code

Country Required if not US

Telephone (Format: xxx-yyy-zzzz)

E-mail

Planned Participation

Affiliates Dinner, Thursday, April 23

Affiliates Meeting, Friday, April 24

New England Statistics Symposium, Saturday, April 25 (ARA funds may be used for registration fee, and extra night of lodging.)

Special Requests

If you have special requests (such as dietary restrictions), please enter them below. Other questions should be sent by E-mail to 2009affiliatesannualmeeting@niss.org.

Participant Information

Planned Participation

Special Requests

Submission