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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Area Code
Phone Number
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4
Chapter Name
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5
NSBE ID
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6
Membership Level
NSBE Jr.
Collegiate
Professional
Lifetime
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7
Corporate/University Partners: (Company Name)
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8
Presenter/Panel Speaker
YES
NO
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9
Resume
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10
LinkedIn (ex. www.linkedin.com/Janedoe)
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11
Dietary Restrictions
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12
Emergency Contact Name
First Name
Last Name
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13
Emergency Contact Email
example@example.com
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14
Emergency Contact Phone Number
Area Code
Phone Number
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15
COVID-19 Policy: All Summit Attendees must be fully vaccinated. Fully Vaccinated means: Two weeks after receiving their second dose in a two-dose series, such as the Pfizer or Moderna vaccines. OR two weeks after receiving a single-dose vaccine, such as Johnson & Johnson's vaccine. Unvaccinated summit attendees must have proper and approved documentation of religious exemption or medical exemption. NSBE-approved exemption documentation templates and submittal form are publicly available on the NSBE website. Religious exemption / medical exemption is the only way to attend NSBE meetings/summits/conferences without being fully vaccinated. All attendees must submit a negative covid test completed 48 hours before the summit, if not vaccinated. By clicking yes below, you are agreeing to the terms and conditions above, to show vaccination/exemption status, and negative covid test completed 48 hours prior to summit.
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