NFSN Member Convening Registration
May 18-21, Arlington, VA and Washington, D.C.
REGISTRANT INFORMATION
Toda3/2/y's Date
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Month
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Day
Year
Date
Email
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example@example.com
Name
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First Name
Last Name
Organization Name
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Title
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Network State
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Phone Number
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(XXX) XXX-XXXX
Format: (000) 000-0000.
If you would like to pay for additional registrants, please select the number:
Please Select
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2
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Registrant 2 Name
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First Name
Last Name
Registrant 2 Email
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example@example.com
Registrant 2 Phone Number
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(000) 000-0000
Registrant 2 Organization
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Registrant 2 Title
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Registrant 3 Name
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First Name
Last Name
Registrant 3 Email
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example@example.com
Registrant 3 Phone Number
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(000) 000-0000
Registrant 3 Title
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Registrant 3 Organization
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Participant Information
Do you plan to attend the Networking Reception planned for Tuesday, May 19th 5:00-6:30pm?
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Yes, I'll be there!
No, I have another committment
I'm not sure yet
Please list any dietary restrictions here:
Please list any accommodations that you may need related to mobility, hearing, vision, etc. (no dietary information here please):
Payment and Invoicing Information
If you click "invoice me" you must still select the correct quantity of registration and baseball tickets desired. Use the code INVOICE below and you will not be required to submit credit card information.
Enter discount code to apply discount to payment products or pricing
Invoice me
Provide invoice notes here (email of recipient,
Registration
Early Bird Registration $650
Regular Registration $750
Late Registration $850
Ticket to Mets at Nationals Baseball Game ($28)
Join fellow NFSN Members at the Nationals baseball game on Wednesday, May 20 6:45pm ET, section 240. Tickets include a $8 meal voucher.
Total Cost
Early Bird Registration
Regular Registration
Late Registration
Payment Amount
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( X )
USD
Description
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Registrant 4 Name
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First Name
Last Name
Registrant 4 Email
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example@example.com
Registrant 4 Phone Number
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(000) 000-0000
Registrant 4 Title
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Registrant 4 Organization
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Registrant 5 Name
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First Name
Last Name
Registrant 5 Email
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example@example.com
Registrant 5 Phone Number
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(000) 000-0000
Registrant 5 Title
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Registrant 5 Organization
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Submit
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