Registration
Name: First and Last
Your answer
Preferred Mailing Address
Street
Your answer
City, State, Zip Code
Your answer
Email Address
Your answer
Phone Number
(---)--------
Your answer
Attendee Registration
Includes Friday evening Welcome Reception, all technical sessions, Saturday lunch, and afternoon reception with hors d'oeuvres on Saturday. Dinner on Saturday will be on our own.
Accompanying Person and/or Child Registration
Age 12+: Includes Friday evening reception; Saturday lunch and late afternoon reception with hors d'oeuvres.
Accompanying Child Registration
Age 2 - 11: Includes Friday evening reception; Saturday lunch and late afternoon reception with hors d'oeuvres.
Other Meal Requirements
Your answer
Total Number of Accompanying Persons
Your answer
Names of Accompanying Persons
Your answer
Attendee Network Membership for 2017-18
Donation
I would like to make a donation to support Symposia Scholarships and other Outreach Activities. Enter amount below.
Your answer
Total Payment to be Submitted
Enter amount below.
Your answer
Symposia: Consider Presenting
Technical Presentations & Posters
Members would love to hear about your work, research, and/or recent activities. Allow us to support you by learning more about your career! Deadline to submit is October 7.
Title of Presentation or Poster
Help start a great conversation! Please provide a short title for your presentation or poster. If you choose not to submit your idea or abstract today, send your information to nmnwse@gmail.com. Deadline to submit is October 7.
Your answer
Abstract of Presentation or Poster
Help start a great conversation! Please provide a short summary abstract of what you will include in your presentation or poster. If you choose not to submit your idea or abstract today, send your information to nmnwse@gmail.com. Deadline to submit is October 7.
Your answer
Lodge
Lodge Accommodations
The Symposia will be held at the Murray Hotel in downtown Silver City. To reserve your room, call 575-956-9400, and share that you are making the reservation as a member of the AAUW and NMNWSE group. The special room rate is $89, plus tax/fees. To view the website, visit https://www.murray-hotel.com/.
Board
Would you be willing to run for the 2017-18 NMNWSE Board of Directors?
Will you be attending the Sunday morning NMNWSE Board Meeting? It is the first meeting of the 2017-18 Board, and open to all members.
Scholarship Request
Would you like to apply for a Symposia Scholarship?
Available to students, teachers, and non-employed members presenting posters, and those in need.
If applying for Symposia Scholarship, provide a thoughtful personal summary for the reasoning behind why you should receive this award.
If applying for a scholarship, please contact the meeting registrar for scholarship status prior to submitting payment. Deadline to submit is September 30.
Your answer
Connect
Please contact me:
Special Accommodations | Other Comments
Please enter any additional information you wish us to consider when planning this event.
Your answer
Payment
Required
Don't forget to click the Submit button!!
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms