PASS:PORT Application

Apply for IWP's 2012-13 PASS:PORT program

All fields are required.  All information will be kept confidential and unless the nominee is chosen to participate in the PASS:PORT offering, all data will be used only to identify levels of interest and nature of prospective involvement.

Name (Surname, first name)  * 
Professional title  * 
Agency  * 
Nominated by  * 
 Self
 Supervisor
 Colleague
 Other
Location  * 
Your email address  * 
Best phone number to contact you  * 
Best way and time to reach you  * 
Your role in US national security (100 words or fewer)   * 
Reason or motivation to engage with PASS:PORT (100 words of fewer)  * 
Your CV or resume  * 
Do you have any special dietary requirements? (If yes, we will follow up later to accommodate)  * 
 Yes  No
If admitted, please send my invoice to: (Please include organization, name, address, phone number, and email.)  * 
* Required



IMPORTANT NOTICE: Certain US government users have experienced difficulty registering successfully through this page. All registrants should receive an email acknowledgement immediately. If you do not do so, please email Linda Strating at strating@iwp.edu, or call her at 202-462-2101 ext. 319, to register by email, phone or fax.