2018 VASEM Summit - Apply to Attend

Participation in the 2018 VASEM Summit on Securing Prosperity in the Coastal Zone is by invitation only. Participant selection will be guided by the Summit's goal "to move towards a holistic conversation about promoting prosperity in Virginia’s coastal zone and its role in the Nation’s well-being, across geographic and government scales," with emphasis on diversity across multiple areas, including disciplines and organizations. We anticipate 150 to 200 attendees at the 2018 Summit, where about one third will be drawn from those applying to attend.

To apply for an invitation, please enter below your contact information, employer information, areas of expertise, and a short statement of interest in attending the Summit. If invited to attend, at registration a $75 registration fee will be collected to support dinner and coffee break expenses.

Application review will begin on July 20, 2018 and continue until all open seats are filled.
Email address *
Virginia Academy of Science, Engineering and Medicine
2018 VASEM Summit
*
First Name *
Your answer
Last Name *
Your answer
Job Title *
Your answer
Employer type (if retired, select most recent) *
Organization/Employer *
Your answer
Department (or equivalent) *
Your answer
Street Address *
Your answer
Street Address 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Country (if not USA)
Your answer
Phone Number *
Your answer
Areas of expertise *
Your answer
Short statement of interest in attending the 2018 VASEM Summit (1000 character limit) *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Virginia Tech.