## ![](media/image1.png){width="1.2in" height="1.2in"}

+--------------+--------+----------+------+---+---+-----------+----------+
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+--------------+--------+----------+------+---+---+-----------+----------+
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|              |        |          |      | s |   |           |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
| Name for     |        |          |      |   |   |           |          |
| workshop     |        |          |      |   |   |           |          |
| badge:       |        |          |      |   |   |           |          |
| **     **    |        |          |      |   |   |           |          |
+--------------+--------+----------+------+---+---+-----------+----------+
| Rank, Title, |        |          |      |   |   |           |          |
| or Position: |        |          |      |   |   |           |          |
| **     **    |        |          |      |   |   |           |          |
+--------------+--------+----------+------+---+---+-----------+----------+
| *Provide     |        |          |      |   |   |           |          |
| Proof of     |        |          |      |   |   |           |          |
| U.S.         |        |          |      |   |   |           |          |
| Citizenship  |        |          |      |   |   |           |          |
| to Workshop  |        |          |      |   |   |           |          |
| Clearance    |        |          |      |   |   |           |          |
| Coordinator  |        |          |      |   |   |           |          |
| (WCC) [BY    |        |          |      |   |   |           |          |
| 9/8/08]{.    |        |          |      |   |   |           |          |
| underline}:* |        |          |      |   |   |           |          |
|              |        |          |      |   |   |           |          |
| *Jeanette    |        |          |      |   |   |           |          |
| Laslo,       |        |          |      |   |   |           |          |
| Phone: (505) |        |          |      |   |   |           |          |
| 284-5668,    |        |          |      |   |   |           |          |
| Fax: (505)   |        |          |      |   |   |           |          |
| 845-3651,    |        |          |      |   |   |           |          |
| email:       |        |          |      |   |   |           |          |
| jlaslo       |        |          |      |   |   |           |          |
| @sandia.gov* |        |          |      |   |   |           |          |
|              |        |          |      |   |   |           |          |
| Proof may be |        |          |      |   |   |           |          |
| copy of      |        |          |      |   |   |           |          |
| birth        |        |          |      |   |   |           |          |
| certificate, |        |          |      |   |   |           |          |
| passport, or |        |          |      |   |   |           |          |
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| papers.      |        |          |      |   |   |           |          |
+--------------+--------+----------+------+---+---+-----------+----------+
| Please       |        |          |      |   |   |           |          |
| provide the  |        |          |      |   |   |           |          |
| following    |        |          |      |   |   |           |          |
| information  |        |          |      |   |   |           |          |
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| for          |        |          |      |   |   |           |          |
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| processing): |        |          |      |   |   |           |          |
+--------------+--------+----------+------+---+---+-----------+----------+
| \*Social     |        |          |      |   |   |           |          |
| Security     |        |          |      |   |   |           |          |
| Number :     |        |          |      |   |   |           |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
| \*Birth      |        |          | \*P  |   |   |           |          |
| Date:        |        |          | lace |   |   |           |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
| Business/O   |        |          |      |   | T |           |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
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+--------------+--------+----------+------+---+---+-----------+----------+
| Mobile Phone |        | Fax:     |      |   |   | email:    |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
| **Ad         |        |          |      |   |   |           |          |
| ministrative |        |          |      |   |   |           |          |
| Contact:     |        |          |      |   |   |           |          |
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| Telephone: ( |        |          |      |   |   |           |          |
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+--------------+--------+----------+------+---+---+-----------+----------+
| ###          |        |          |      |   |   |           |          |
+--------------+--------+----------+------+---+---+-----------+----------+

+-------------+-------------------------------------+---+--------+-------+
|             |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+
| Workshop    | Day 1, 9/23/08: Continental         |   |        | \$    |
| Fee         | Breakfast, Lunch and refreshments   |   |        | 30.00 |
+-------------+-------------------------------------+---+--------+-------+
|             |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+
| Social      | 9/22/08, 6pm, @ MCM Elegante Hotel: | \ |        | \$    |
| Mixer       | Opportunity to network and receive  | $ |        |       |
|             | workshop materials prior to         | 1 |        |       |
|             | meeting; mixer includes heavy       | 6 |        |       |
|             | hor'deurves and no-host bar         | . |        |       |
|             |                                     | 5 |        |       |
|             |                                     | 0 |        |       |
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+-------------+-------------------------------------+---+--------+-------+
|             |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+
| Workshop    | 9/23/08, 7pm @ MCM Elegante Hotel;  | \ |        | \$    |
| Dinner      | no-host bar; and indicate:          | $ |        |       |
|             |                                     | 4 |        |       |
|             | Petite Filet w/béarnaise and Tiger  | 0 |        |       |
|             | Shrimp \# **  **                    | . |        |       |
|             |                                     | 0 |        |       |
|             | Salmon w/orange brandy sauce and    | 0 |        |       |
|             | Tiger Shrimp \# **  **              | / |        |       |
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|             |                                     | * |        |       |
|             |                                     | * |        |       |
+-------------+-------------------------------------+---+--------+-------+
|             | TOTAL paid on Webpay via Website :  |   | \$     |       |
|             |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+
| *Please     |                                     |   |        |       |
| indicate    |                                     |   |        |       |
| any special |                                     |   |        |       |
| dietary     |                                     |   |        |       |
| requests:   |                                     |   |        |       |
|      *      |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+
|             |                                     |   |        |       |
+-------------+-------------------------------------+---+--------+-------+