U.S. Naval Academy
Annapolis, Maryland

Non-Service Academy Student Registration Form
Naval Academy Science and Engineering Conference (NASEC)
Sunday, 4 November through Tuesday, 6 November 2012
 

Please complete and click on the SUBMIT button at the end of this form.

Registration CLOSED at 1600 on Friday, 26 October 2012. 

Please send an e-mail message to Prof. Malek-Madani (reza.malekmadani@navy.mil)  --  to ask about late registrations  -- prior to completing the registration form. 

*Asterisks indicate required fields.

Disclaimer: Information is for conference use only and will not be released.

 
Personal Information
 
Last Name*
First Name*
Preferred Name on Badge*
College/University*
Your USPS Mailing Address*
 		 Street
City State Postal  Code
Phone Number* Cell Other
Email*
Re-enter Email*

 

Lodging and Meal Information
 
Lodging and meals will be provided by the conference host. (See Web site for specifics.) Students will be housed in double occupancy rooms in a local hotel within walking distance of the Naval Academy. A continental breakfast will be provided at the hotel on Monday and Tuesday mornings.
 
I will need lodging for the nights of:* Sunday, November 4
Monday, November 5
I will NOT need lodging
 
We will be housing students in double occupancy rooms.  Thus, you may be assigned a room with a student from another institution. Please provide information to help us make the room assignments.
 
Gender Male Female
 
Please indicate any special needs for food or housing purposes. Special food needs MUST be pre-arranged with the caterer. Only those who indicate their needs on this form will be accommodated at meals and breaks.   Gluten Intolerant
 Vegetarian
 Lactose Intolerant
 Need ADA Compliant Housing

 

Conference Information (Sunday, 4 November  -  Tuesday, 6 November)
 

The expectation is that participants will attend all three days of the conference.  Requests for attendance on fewer days will be accommodated as space allows.
 

I will attend the conference on*
All three days
Sunday, November 4
Monday, November 5
Tuesday, November 6
 

The conference has three concurrent sessions:

  • Energy and Alternative Fuels

  • Cyber Space and Security

  • Water and Sustainability

Please consult the NASEC 2012 Web site for brief descriptions of the sessions, and then indicate your preference for session attendance throughout NASEC 2012.
 
  1st Choice 2nd Choice 3rd Choice

Energy and Alternative Fuels*

Cyber Space and Security*
Water and Sustainability*
     

Poster Session
 
NASEC 2012 will feature a poster session to showcase student work. STEM-related posters are solicited in the areas of open-ended course projects, capstone projects, and research projects. Prizes will be awarded for the top posters in each category. More details regarding the format, content, and judging of posters can be found on the NASEC 2012 Web site.
 
Are you interested in presenting a poster based on a course or research project in one of the three topic areas of the concurrent sessions (listed above)?* 
 
Yes
 No
   

If YES, please provide the title of your poster.    

   

Please provide a short description of the course project or research effort that led to your poster. 

 
Please indicate below the poster category in which you would like to participate:
  Open-ended course project
Capstone project
Research project
 
The poster CANNOT be larger than 32” X 40”.  We will supply an easel, foam board and push pins for display purposes. 
Please see the NASEC 2012 Web site for suggested poster format.

 

Emergency Contact Information
 
Last Name*

First Name*

Relationship

Day Phone* Ext 

Evening Phone*

Email