Registration: Contact Information
* Indicates a required field.
  Or enter one here   
Name* (First, Middle, Last)
Suffix            Or enter one here 
Badge Name*

Are you registering as a student? YES | NO
E-Mail Address*
E-Mail Address Confirm*
Address Line 1*
Address Line 2 (Optional)
Address Line 3 (Optional)
State/Province (Required for U.S. and Canadian Addresses)
 or enter one here:
Postal Code*
Enter complete phone and fax numbers, including country code.
IEEE Membership Number (if applicable)
Dietary Requirement
MTS Membership Number (if applicable)
If your dietary or other needs are not covered by the pull-down menu, please describe your requirements for us here:
You must provide your IEEE or MTS membership ID (numeric values only) in order to receive membership registration rates.

© 2012 OCEANS'12 MTS/IEEE HAMPTON ROADS -- All Rights Reserved. BluStreak Design