NBEA Conference Registration Form 2018
Last Name / Family Name / Surname *
If you use Jr or II or something else as part of your name, please add it here. For example, OBrien Jr.
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First Name *
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Middle Initial
Please enter the initial of your middle name if you use one.
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Affiliation (University or Company) *
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Please choose your academic status *
email address *
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Mail Address 1 *
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Mail Address 2
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City *
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State *
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Country *
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Zipcode
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Phone Number
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First Name for Name Badge
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Area of Specialty
Are you willing to be a session chair?
Do you have co-authors? If so, please list their names here.
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Will you bring a guest?
Remember YOUR meals are included in your registration fee. Guest meals are extra.
Will your guest attend:
How will you pay your registration fee? *
(Checks should be made payable to Northeast Business & Economics Association and mailed to William O'Brien, attention NBEA Worcester State University Department of Business Administration and Economics 486 Chandler Street Worcester MA 01602)
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