Registration (International) International registration form Please remember to submit a clear copy of the entire picture page of your passport, which must be valid until [DATE], using the Documents link above. Thank you. First Name Middle Name Last Name Home Address Home Phone Number Gender femalemaleother Date of Birth Enter a date in the format YYYY-MM-DD Birth City Birth State Birth Country Country(ies) of Citizenship Passport Number Passport Expiration Date Enter a date in the format YYYY-MM-DD Passport Country Visa type Visa Issue Date MM/DD/YYYY Visa Expiration Date MM/DD/YYYY Is a Letter of Invitation required for your visa application? noyes Do you require travel assistance? noyes Do you have any special dietary needs? None Gluten Free Vegetarian Lactose Intolerant Vegan Nut allergy Kosher Halal Name Tag Information How your name will appear on your name tag Employment Information Job Title Years In This Position Less Than 1 Year1 to 5 Years6 to 10 YearsMore than 10 Years Company Name Facility Name if different from Company Name Company Address 1 Company Address 2 Facility Address if different from Company Address Facility Address 2 if different from Company Address Company City Company State Company Zip Code Your E-Mail Address Company Country Business Phone Mobile/Cell Phone in case there are issues during travel Have you been to Los Alamos National Laboratory before? yes no Do you have a close relative employed at LANL? yes no Your Discipline/Area of Expertise recaptcha