NSC Residence Hall and Meal Request
Required information is denoted with a red asterisk (*).
Your request can NOT be submitted without providing information for these fields.

Contact Information
Group Name/Organization:*
Group Leader Name: *
Address: *
City: *
State/Province: *
Zip: *
Country: *
Primary Phone: *
- -
Area Code
Secondary Phone: *
- -
Area Code
Email Address: *
Are you attending an NSC event? Yes    No
        If 'Yes', what event?

Total Number to Accommodate
Males: * 19 and younger:       20 and older:  
Females: * 19 and younger:       20 and older:  

Room Request
Arrival Date: *   
Approximate Arrival Time: *
Hour       Minute
Departure Date: *   

Meal Request
Please include the dates on which you will need meals
Breakfast Lunch Dinner