Attendee Registration

Please select how many people you are going to register for this event by selecting from the below radio buttons and drop down. If you are not attending, but are just registering others from your company and would like to be the group contact, please select "I will not be attending". This will ensure that you receive all communication that your attendees receive.

Group Contact

I am a group contact and I will not be attending.

Group Contact

Contact Details

First Name

Last Name

Organization

Email Address

Verify Email Address

Group Members

Group Size

Contact Details

Prefix/Title

First Name

Last Name

Suffix

Badge Name

Organization

Job Title

Email Address

Verify Email Address

Work Phone

Mobile Phone

Mobile Phone Type

Primary Address

Street Address Line 1

Street Address Line 2

Street Address Line 3

Address City

Address State

Address Country

Address Postcode

Address Type

How did you learn about this event?

NAMIC Electronic Promotion

NAMIC Online Website

NAMIC Printed Promotion

Social Media

Word of Mouth

Other Industry Website

What is the general category of your job title?

Business/Product Development

C-Suite or Vice President

Innovation Specialist/Manager

Manager or Managing Director

Other Industry Professional

President/CEO/Company Manager

Technology Specialist/Manager

Number of years in your position:

Less than 1 Year

1-5 Years

6-10 Years

11-15 Years

16-20 Years

21+ Years