Conference Substitution

Tell us about yourself

information for the person making this request

Company*

Name*

First Last

Business Email*

Current Attendee Name*

First Last

New Attendee Name*

First Last

New Attendee Business Title*

New Attendee Business Email (email domain must match member company)*

New Attendee Business Phone*

New Attendee's Admin Email

Is this individual a first time attendee?*

Any dietary restrictions or other needs we should be aware of?

Emergency Contact Name*

First Last

Emergence Contact Phone*

Event Data Disclosure Agreement & Code of Conduct*

Yes, I have read and agree to the NASCIO Event Data Disclosure Agreement and Code of Conduct

COVID-19 Liability Waiver*

NASCIO highly recommends that conference attendees are vaccinated for COVID-19 or have a negative test prior to attending a NASCIO event.

Yes, I have read and agree to the NASCIO COVID-19 Liability Waiver.