Workshop and Banquet Registration

Please complete the following information to register for the 2008 HPEC Workshop.

* Prefix: 
* First Name:     Middle:
Preferred Nickname:  (Optional) 
* Last Name: 
* Organization: 
* Address1: 
* City:      * State:     * Zip:
* Phone: 
* E-mail: 

* Please specify the event(s) you are requesting to attend:

Workshop only
Workshop and banquet
Workshop only as student
Workshop and banquet as student

Please check appropriate citizenship status:

United States Citizen
U.S. Permanent Resident (Green Card Holder)
Note: You will be required to show your Green Card to the Security Office EACH day you attend the workshop.
  * Primary Country of Citizenship:
Foreign National
* Country of Citizenship:
Visa Holder
* Country of Citizenship:
* Please indicate visa type:
  Note: Foreign Nationals and Visa Holders are required to fill out MIT Lincoln Laboratory’s Foreign National Visit Request Form, requesting approval to attend this workshop. This form will be included in the Invitation Package.
* Please check appropriate affiliation:
* Please indicate whether you have special requirements, e.g., handicap access needs, dietary restrictions, etc.
Yes. I will email my requirements to the HPEC Workshop Office,
Please indicate if you DO NOT want your name to appear on the Attendee/Registration list.
      * Required fields