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Online Conference Registration Form


Online Registration

Hotel Information

Draft Agenda

Transportation Directions

Contact Information


To register for the conference, complete and submit the following form.  The last date to register online is April 5, 2006.  After this date, please contact Mr. David Smith at 703-555-3831 or by e-mail at david.smith@infinityconferences.com.
On completion of the form, please press the "Submit" button. You will receive immediate confirmation upon proper submission.  Please print and retain for your records.

If you have any questions about the online registration or the conference, please contact Infinity Conference Group by phone at 703-925-9455, ext. 0, or by e-mail at icg@infinityconferences.com 
 

Attendee Information

   Note:  All fields marked with an " * " are required.

*Prefix (e.g. Mr., Ms., Mrs., LTC., MAJ., etc.):
*First Name:
Middle Initial:
*Last Name:
*First and last name as you
want them to appear on badge:
*Rank:
Position:
*Organization:
*Type of Organization:
*Address:
Address (cont.):
Address (cont.):
*City:
*State:
*Zip:
*Commercial Phone Number:
(e.g. 555-555-5555)
DSN Phone Number:
*E-Mail:
   

*Please identify forms of ID
(Check all that apply):

 Active Duty ID Card
Pentagon Access Badge
Common Access Card
None of the Above
   

*Please select if you will be
attending the conference using
federal government travel orders:

 Yes   No


*Check events you plan to attend:
MACOM Working Group Session - January 10
Reception - January 11 (Note: A $15 payment will be required for those attending the reception on 11 January.  Sending organizations are responsible for the cost of travel, per diem, and lodging.  There are no other costs associated with the conference.)
Conference - January 11
Conference - January 12
Dinner and Guest Speaker Event - January 12
    (Note: Attendees will not be required to pay for dinner)
Conference - January 13
 

*Dietary Preferences
 (Dinner only):
Note: This is a required field.  If you are not participating in the dinner please check Not Attending.

 

 


Other dietary requirements - please specify:

(e.g., vegetarian, low sodium, allergies,  kosher, etc.)

Roasted Pork Tenderloin (Sliced pork tenderloin with

lavender wine reduction featured with sweet potatoes au gratin)

Chicken Roma (Breast of chicken topped with sun dried

tomato and basil cream sauce)

London Broil (Marinated Flank Steak, grilled, sliced and

finished with bordelaise sauce)

Not Attending Dinner
 




 

The Hilton Crystal City at Reagan National Airport is an accessible facility but if there are special accessibility requirements, please specify: