CONGRESSIONAL STAFF REGISTRATION

Attendee Information

First Name *:
Last Name *:
Title:
Organization *:
Street Address *:
Street Address 2:
City *:
State *:
Country:
ZIP *:
Phone *:
Cell Phone:
Your Twitter Handle:
Fax:
E-Mail *:
Please make sure that this is a valid email account.
Your receipt for payment and/or the hotel acknowledgement will be sent there.
If you would like a second copy of your confirmation sent,
please enter the e-mail address here:
Preferred Name on Badge (FIRST NAME ONLY)*:
Attendee(s) has special needs *:
Yes No
If Yes, Please Specify:
 

Name of Accompanying Spouse/Partner:
No registration fee for spouse/partner.
First and Last Name of Spouse/Partner:
Spouse/Partner Gender:
Male Female


Registration Payment Information

Registration Fees:

Late/On-Site Registration Fee
(After May 4, 2018 and On-Site):
$1,050


Refunds will be made for cancellations received in writing by May 4, 2018 (less a $200.00 service fee). NO REFUNDS will be made for cancellations received after May 4, 2018.


Will you be requesting a hotel room? *  

NOTE: If you select "No" a link will be included in your confirmation email that will allow you to request a room at a later time.