Building and Sustaining Quality in NRS Data
  
 

Please register for the Building and Sustaining Quality in NRS Data meeting by completing the registration form below, which requires your full contact information, selected location for the regional training, and sponsorship. Note that state-sponsored attendees must submit their registration fee by check according to the instructions that follow.  To complete this form, please click Register!

Payment Information
*Sponsorship:
Note: NRS-sponsored attendees will receive reimbursement from the NRS project for airfare, hotel, meals and travel expenses. State-sponsored attendees must be reimbursed by their state.
Type of Payment Provide check or Purchase Order number in the space provided if you are a state-sponsored attendee.
Participant Information
*Name:
  Title:
*Agency/Organization:
*Address:
 
    
*Phone:    Ext
 Fax:
*Email:  
Registration Information
  Conference Date Select one of the 3 following locations
(Note: you must select the same location as your state team; states are strongly encouraged to attend the training in their region)
 Special Needs: Please indicate if you have a disability that will require specific aids/services, e.g., wheel chair access, American Sign Language interpreter

 Special  Dietary
  Needs:

Please indicate if you have a special dietary need such as a food allergy, vegetarian, or kosher