Online registration

* = Required Field

Name

* Last

* First

Citizenship

I am a Citizen of:

Contact

* Email Address

* Telephone Number

Permanent Address

* Street

* City

* State

Zip Code

Contact In Case Of Emergency

* Name

* Relationship

* Telephone Number

School

I am currently a:

* Name Of School

* School City

State

Every attendee must have a photo ID or school ID

* School ID#

* Nano*High Dates

How will you be arriving at Nano-High?

Free shuttle bus. Last shuttle will depart from Downtown Berkeley BART at 9:30am
I will be dropped off and picked up. (Please provide Driver information in the fields below below.)
I will need parking. (Please provide Driver information in the fields below below.)

Driver's Name

		* = Required Field Name * Last * First Citizenship I am a Citizen of: Contact * Email Address * Telephone Number Permanent Address * Street * City * State Zip Code Contact In Case Of Emergency * Name * Relationship * Telephone Number School I am currently a: * Name Of School * School City State Every attendee must have a photo ID or school ID * School ID# * Nano*High Dates October 27, 2007 November 17, 2007 January 12, 2008 February 9, 2008 March 8, 2008 April 12, 2008 How will you be arriving at Nano-High? Free shuttle bus. Last shuttle will depart from Downtown Berkeley BART at 9:30am I will be dropped off and picked up. (Please provide Driver information in the fields below below.) I will need parking. (Please provide Driver information in the fields below below.) Driver's Name