2023 Conference Mail-in Registration PDF 2023 Conference RegistrationSee our website for hotel reservations link, schedule, delegate info, etc.Nicotine free in 2023. For help with registering contact nicawsc@gmail.com RM_StatsFirst & Last Name *Type your first and last name in this fieldEmail *Enter email again *Address of Attendee Address Line 1 * Address Line 2 City * State or Region * Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and the McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iran Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country * Zip * Attendee's Phone Number *Emergency Contact for Baltimore AttendeesEmergency Contact Phone Number for Baltimore attendeesPlease include country code if outside USNOTE: Each conference attendee must register separately.Registration * I will be attending online ($ 55) I will be attending in-person in Baltimore, MD (Sat/Sun daytime snacks/drinks & lunch included) ($ 110) I will be attending the Friday Board in-person (Fri snacks & lunch incl.) ($ 35) I am registering as a delegate for the 2023 NAWS conference. NOTE: Please remember to email the NAWS Secretary Emeritus at Secretary-emeritus@nicotine-anonymous.org to complete the process of registering as a delegate for the 2023 NAWS conference. * Yes No I am attending in-person and am staying at the Maritime Conference Center Yes – Daily breakfast and dinner are included with your hotel registration ($ 0) No – Additional charge for the Saturday dinner ($ 45) I am bringing a friend that is not registering for or attending the conference in-person Yes – Additional charge for the Saturday dinner ($ 45) Yes – Additional charge for the Sunday lunch ($ 35) No – No additional meal charges apply ($ 0) I require a special diet:Select an optionVeganVegetarianOther: add info belowI would like to make a donation to Nicotine Anonymous to help offset the additional technology expense required to host a hybrid conference.Select an optionI would like to donate ($ 10)I would like to donate ($ 25)I would like to donate ($ 50)I would like to donate ($ 100)I would like to donate ($ 200)×I would like to volunteer in the following way for the conference. Registration table Setup Onsite Tech - Zoom hosts Table decorations Tear down Hospitality room Remote Tech - Zoom Co-hosts Notes Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.