Please complete the form below

Speaker Information

First Name

Last Name

Agency/Organization

Office Phone

(###)

###

####

Personal Cell, for use only for weather delay/cancellation to contact attendee directly

(###)

###

####

Email Address

POC First and Last Name

POC Email Address

POC Phone Number

(###)

###

####

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. Per the Joint Travel Regulation (JTR), if you traveling from within 50 miles of the course location you are not entitled to reimbursement or travel related expenses and do not need to complete anything other than arrival and departure dates.

Arrival Date

What date will arrive

YYYY

Estimated Arrival Time

Departure Date

YYYY

Estimated Departure Time

Where are you traveling from? (City, State)

Number of lodging nights needed

Airfare Estimate

As a government traveler you are only authorized an economy seat.

Rental Car Estimate

Checked Baggage Fees

As a government traveler you are only authorized one checked bag each way

Tax, Uber, etc. Estimate

Parking at Airport

Mileage To Airport From Home (one-way)

Mileage to Ritz Carlton, Pentagon City from Airport (one-way)

Please complete this field if you intend to drive to the Ritz Carlton, Pentagon City and are entitled to travel reimbursement.

Any Dietary Restrictions we should be aware of:

ASLDPII 24A Speaker Registration

Please complete the form below