Forum Faculty Registration Forum faculty role* Panelist Paper Writer/Presenter Speaker (lunch/welcome) Discussion Group Moderator Name* First Middle Last Preferred Badge Name (we use first names)* Title* Organization* Address* City* State* Zip* Email* Office Phone* Cell Phone* Assistant Name Assistant Email Assistant Phone Emergency Contact Name/Phone*Please provide contact information for someone who can be reached in the event of an emergency during the Forum weekend. I plan to include a slideshow or video presentation at the Forum* Yes No Will advise CommentsDietary/Accessibility Requests Please upload a brief (1-2 paragraph) bio in Word *AND* your head shot (JPG/PNG)If you're unable to upload these items, please email them to mary.collishaw@ncji.org. Drop files here or Select files Max. file size: 50 MB. I will attend the Forum faculty dinner on Friday, July 19, 7:30-9:00 pm*This is a working dinner meeting. All faculty are asked to attend. Yes No Will advise I will attend the post-Forum reception on Saturday, July 20, 5:00-6:00 pm*A casual reception immediately following the Forum for judges and faculty. We ask all faculty members to attend. Yes No Will advise I will attend the NCJI Fellows Reception on Sunday, July 21, 5:00-6:30 pm*NCJI's board invites Forum faculty and judges to this festive celebration of NCJI's work. Yes Yes with a guest No Will advise