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Step 2: Bioskills Lab Registration

Please complete the fields below, then click the Complete Sign-Up button at the bottom:

* Required

Point of Contact:

Your Name: *

Title: *

Phone: *

(Format: 000-000-0000)

Email: *

(this will also be your username)

Password: *

Confirm Password: *

Lab Info:

Company Name: *

Address Line 1: *

Address Line 2:

(Suite/Room #)

City: *

State: *	Zip: *

Short Description of Lab:
(max 500 words) *

Lab Email: *

Lab Phone: *

(Format: 000-000-0000)

Website: *

(FULL link, including "http://")

Hours of Operation: *

(Example: Mon - Fri, 9am - 5pm.
Sat 10am -pm. Closed Sun.)

Minimum # of Stations: *

Maximum # of Stations: *

Wet Lab: *

Conference Seating: *

Seating Capacity: *

A/V Capabilities: *

Sterilizer: *

Closest Major Airport: *

Airport Distance
From Lab: *

Example: 5 miles

Upload Images:

Company Logo:

Click the Browse button below to locate a file on your computer:

Company Logo image must be in JPG or PNG format, with white or transparent background, RGB color mode (not CMYK), and maximum file size of 2MB.

Please Confirm You Are Human (Anti-Spam]: