Speaker Information:

First Name

Last Name

Agency/Organization

Do you require a name badge?

Yes

No, not required

Go By Name for Badge

if not required write N/A

Personal Cell, for use only for weather delay/cancellations

(###)

###

####

Email Address

Presentation/Slides Preference:

I will not have a presentation or slides.

I will advance my own slides.

I would like Flatter to advance my slides on my cue.

Microphone Preference:

I will not use a microphone.

Lapel microphone

Hand held microphone

Accommodation Information

For those authorized travel via contract, government approval is required (Flatter, Inc. will execute this). Estimates that change MUST be coordinated and approved by Flatter, Inc. and the government prior to travel to the Bolger Center. Once the form is filled out, Flatter will make your hotel accommodations and prepare your Travel Authorization for approval.

Arrival Date/Time

Departure Date/Time

Number of lodging nights required:

Will you be joining us for any meals during your stay? If so, please indicate the date and breakfast, lunch or dinner:

If lodging is not required, please indicate the day and meal you will be staying for:

Please list any special accommodations:

Where are you traveling from? (City, State)

Airfare Estimate and Airport Departure Code

if applicable

Rental Car (at Airport) Estimate

if applicable

Taxi, Uber, etc. Estimate

if applicable

Parking at Airport

if applicable

Personal Vehicle Mileage To Airport From Home (one-way)

if applicable

Please provide details regarding your speaking engagement for

AFCLC-23C (17 - 21 April, 2023)

AFCLC_23C_Speaker Registration

Please provide details regarding your speaking engagement for

AFCLC-23C (17 - 21 April, 2023)