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The NSS Washington Legislative Conference
May 17-18, 2005
Online Conference Registration

If you are an NSS member and the fields below are empty, click
Fields marked with a red asterisk * are required.
Enter "n/a" for fields that do not apply.

Section I – Contact Information

*First Name(s):     *Last Name:  
(Please select your Country first.   If not found, select your Continent to bring up list.)
*Street Address:
*State/Province:     Other:  
Please provide an email address to receive confirmation of this transaction.
*E-Mail Address:
*Phone Number:      
Fax Number:
Membership # (if known):  

Section II – Registration Information

My Congressman's Name is:
I have attended the Washington Legislative Conference (or a similar event) in the past:Yes   No
Registration Options:
Adult $50
Student (requires valid student ID) $25
Senior (65 or older) $25

Registration Fee:



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