2021 NDSEG CLASS CONFERENCE

DoD NDSEG Fellowship Program

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DoD NDSEG Conference Registration Requirements for General Registration (Non-Speakers Only!)

Title/Rank

DoD NDSEG Conference Registration Requirements for Fellows

First Name

Last Name

Job Title

Organization / Institution Name

Work Mailing Address

Address 1

Address 2

City

State

ZIP

Emergency Contact: Name

Emergency Contact: Phone Number

DoD Agency

Affiliation

DoD Agency

Phone Number (Please provide a number that you can be reached during the conference)

Are you a Former Fellow?

Enter Fellowship Year:

Enter DoD Agency Assigned During Fellowship:

Primary Research Discipline Area

Other Research Discipline Area

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Research Discipline Area

Research Title

University (Full Name, No Acronyms)

Anticipated Graduation Date (mm,dd,yyyy) or (month, day, year)

Select the days that you are attending:

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Would you be interested in the opportunity to be an evaluator for posters and technical presentations?

Agency

Would you be interested in serving as a DoD Mentor for upcoming NDSEG Class?

Would you be willing to serve as a Subject-Expert Reviewer for the NDSEG Application?

Acknowledgement/Photo and video-taking

I acknowledge that Photos and videos may be taken during the conference for education and learning purposes. While the DoD is not required to get permission from attendees, we would like every attendee to be aware that images and videos may be captured. By registering for the NDSEG conference, you acknowledge that photos and video may be taken. Contact ndseg@its-jv.com should you have any questions or concerns.

Would you be interested in serving as a Panelist/SME to evaluate applications for the 2024 NDSEG Fellowship? To review eligibility please visit https://ndseg.org/smes

Acknowledgement, fulfilling terms and conditions

By registering for the NDSEG Conference, you understand that, per fellowship terms and conditions, you are required to attend the conference from Sunday, July 30 – Friday, August 4, 2023. If you have any issues, contact ndseg@its-jv.com.

Poster or technical presentation checkbox

As an NDSEG Fellow, you acknowledge that you will be presenting your research progress. All Fellows will present a 15-minute technical presentation on their posters. You are responsible for production of your poster or visuals.

I acknowledge that submission will be due to ndseg@its-jv.com NLT Saturday, May 20, 2023, in accordance with the guidance and template provided by the NDSEG Program Office.

ADA Accessibility Requirement. If you are a qualified individual with a disability or a disabled veteran, do you require reasonable accommodation during the conference?

Please briefly explain your reasonable accommodation needs.

Dietary Restrictions/Meal Preference

Please let us know your dietary restrictions (if any) or meal preference by answering the questions below.

If you are a vegan, please skip this question and move to Strict Dietary Requirements.

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STRICT DIETARY REQUIREMENT | If applicable, please select your strict dietary requirement from the list below:

FOOD ALLERGY | I have the following Food allergy (please select all that apply):

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Follow-ups after registration:

You will receive a link to the Hotel for Room Reservations and Travel guidelines immediately upon registration. Please check you spam or junk folder if you do not receive the link within 20 minutes. You can also reach out to us at ndseg@its-jv.com.

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