Nobel Conference Group Visit

To register your high school group, please complete this form. We will then reach out to you with student registration information.

Primary Chaperone Contact Information

Preferred First Name

Last Name

Display Name (calculated field set to read only and/or hidden)

Title

Email Address

Email Type
(Read only field mapped to Device Type that defaults to email. This form field is in the same group as the above email address and is required to create a phone number on the device table).

Cell Phone Number

School or Group Name

Start typing to search for your school, then click to select it.
If you've searched and can't find your school, type in its full official name.

Lead Chaperone T-shirt Size

Visit Information

What day/s will you attend the Nobel Conference? Please select one.

Tuesday, October 7

Wednesday, October 8

Both Tuesday & Wednesday

Associated High School CEEB

Anticipated number of students

Anticipated number of chaperones

What additional itinerary options would you like as part of your Nobel visit? (Check all that apply)

Overnight Stay in Southwest Hostel - Monday night (limited)

Overnight Stay in Southwest Hostel - Tuesday night (limited)

Campus Tour - Tuesday 3:30 p.m.

Campus Tour - Wednesday 3:30 p.m.

MOTH Story Slam - Tuesday 7:30 p.m.

Does anyone in your group have any accessibility accommodation requests for your time on campus?

Yes

No

How can we help? Please note that some amenities and services are dependent on staff and resource availability.

Additional comments or special requests:

Nobel Conference Group Visit

Reach far. Dig deep. Go Beyond.

Reach far. Dig deep.
Go Beyond.