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Conference Substitution Request
Tell us about yourself
information for the person making this request
Company
*
Name
*
First
Last
Business Email
*
Who is the current registrant?
Current Attendee Name
*
First
Last
Who is joining us now?
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?
*
Yes
No
Any dietary restrictions, ADA accommodations, or other needs we should be aware of?
*
Emergency Contact Name
*
First
Last
Emergency Contact Phone
*
Event Data Disclosure Agreement & Code of Conduct
*
view the
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.
view the NASCIO COVID-19 Liability Waiver
Yes, I have read and agree to the NASCIO COVID-19 Liability Waiver.
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