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* = Required |
YOUR CONTACT INFORMATION |
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NSMN Member?* |
Yes
No |
Appointment Date and Time(1) * |
Date:
Time:
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Appointment Date and Time(2) * |
Date:
Time:
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First name * |
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Last name * |
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Current Title |
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Current Company |
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Prior Title |
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Prior Company |
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Mailing address * |
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City * |
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State * |
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Zip/Postal Code * |
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Phone * |
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E-mail * |
(Receive
NSMN email here) |
Altenate E-mail
(for our files only) |
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Company URL |
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Twitter |
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LinkedIn |
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Please select your
primary chapter * |
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Number of years
in sports business industry? *
(excluding years spent in school) |
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Are you job seeking? *
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Yes
No
(response will remain confidential) |
How did you learn of NSMN? * |
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Referred by? |
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Comments |
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FEE |
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Twitter Workshop ($35)
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PAYMENT INFORMATION |
Credit Card Type * 
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Credit Card # * |
Please no spaces, no dashes |
Expiration Date * |
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Name as it appears on your card * |
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CREDIT CARD BILLING ADDRESS |
Same as above |
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Billing Address * |
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City * |
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State * |
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Zip/Postal Code * |
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