NJSC Registration for Multiple People

NEW JERSEY SCIENCE CONVENTION 2008
You may use this option to both register for convention and purchase meal event tickets.

You should be on this page if you are either registering someone else
OR more than one person - and using your own credit card.
You may register up to 10 people on one credit card transaction.
When done, scroll down to the bottom to submit the form.

Your Name:
Your E-mail:
Number of people on this transaction (maximum is 10): If you are one of the people, please make sure your information is filled in first in the area below.

#1 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#2 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#3 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#4 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#5 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#6 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#7 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#8 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#9 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

#10 Last Name:
First Name:
Home Street Address:
City:
State:
Zip:
Phone:
E-mail:
School District:
Responsibility: (select one)
Level: (select one)
Interest: (select one)
Registering as a member of: (select one)
Attending the following:	Annual Banquet, Tuesday Evening, 10/14 Recognition & Awards Dinner, Wednesday Evening, 10/15

Please check your information for accuracy, then click on the Submit button,
which will take you to Step 3 of the registration process.
Please be patient. This may take 1-3 minutes. Do not submit twice.