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NRC Registration Form
NRC 2019 Registration
*
Name
*
Cell/Phone
*
Email address for NRC
*
KSEA Membership Status?
KSEA Member
KITEE Member
Non-Member Working Professional
Non-Member Student
Please, Type your KSEA Membership No# ( Non member skip this )
*
Current your Company/University
*
Your affiliations ?( As many as yours) *
KSEA NY Metro Chapter
KSEA NJ Chapter
KSEA Philadelphia Chapter
NYKB
PKSA
KASBP
KITEE
Others (University/College/etc)
If you checked quot;Others (University/College/etc)quot;, please specify your affiliation.
*
Your Career Field?
Computer/Data Science
Physical Science
Health/Medical
Engineering
Life Science
**Others
**If you checked quot;Othersquot;, please specify your Career Field.
***
The shuttle bus
will be provided at
7:50am (ONLY once) from Columbia University
(Morningside Campus)
to Montclair State University for NRC 2019.
(
Any other travel support will NOT be provided from NY Metro Chapter.
)
Returning service will also be provided after a networking dinner at NRC 2019.
*
Are you going to take this shuttle bus?
Yes. I will take the shuttle bus.
No.
***We are going to have a complimentary networking dinner
at the conference center right after NRC 2019.
(Not moving anywhere)
*
So are you going to join the networking dinner?
Yes.
No.
*
If so, are you going to drink complimentary Beer/Wine? (Soft drinks will be provided with dinner.)
Yes.
No.
If Yes, your DOB should be checked and a wristband will be provided for your Beer/Wine on your registration.
*
Favorite pastime activity? (Choose one for networking dinner!)
Reading
Exercising
Cooking/Baking
Drawing
Home Projects
No Dinner
*
Field Label
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