NCIPC Board of Scientific Counselors - Registration for December 12, 2018 Meeting

Registration

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* 1. First Name

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* 2. Last Name

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* 3. Affiliation/Organization

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* 4. Email

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* 5. Phone (include area code)

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* 6. Attendance

In-Person
(NOTE: If attending in person, you will be contacted to obtain information so we can submit for your CDC security clearance. We will contact you when we receive your clearance approval. A minimum of 3 days advance notice is needed for processing.)

(NOTE: Please allow up to 10 business days to process clearance approval for all non-citizen.)

Teleconference

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* 7. Are you a U.S Citizen?

Yes