Registration for NISS-NASS Cooperative Research Conference

All workshops speakers and attendees must pre-register.

To register for the Workshop please complete the form below, and then click the SUBMIT APPLICATION button. Items in red are required. Following submission, a confirmation of your application/registration will be displayed. (Print a copy for your records.)

Registration Fee: $100.00

FEES ARE WAIVED FOR NISS AFFILIATES. ( REGISTRATION IS REQUIRED!)

For Credit Card Payments:

Fill out the payment form (PDF file)
Fax it to (919) 685-9331

For Check Payments:

Fill out the payment form (PDF file)
Mail the form and check (payable to NISS) to:

NISS-NASS Opening Workshop Registration
PO Box 14006
Research Triangle Park, NC 27709-4006

Participant Information

First Name Family Name

Organization

Discipline

Address

City

State

Province

Zip (or Postal) Code

Country Required if not US

Telephone

FAX

E-mail

URL

Check here if you are NOT a U.S. Citizen or U.S. Permanent Resident

Interest in the Workshop

Please describe briefly your background and reasons for wishing to participate.

Fee

Affiliate: Fee Waived

Non-Affiliate: $100.00

Status

Student Faculty/Professional

Hotel Requirements

None required

I will make my reservation from the NISS block at the Radisson Research Triangle Park (call 919-549-8631).

I will make my own arrangements.

NISS Affiliates and NISS/SAMSI University Affiliates Only

Check this box if you are from a NISS Affiliate and plan to request reimbursement from your NISS/SAMSI Reimbursement Account.

Special Requests

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