ASA Meeting Participation Form

Meeting Participation Form
Questions
Purpose of trip *
Staff liaison *
How will you participate in this meeting? *

in person via videoconference or teleconference
Event date(s) *
Attendee's name *

First Name Middle Initial Last Name
Attendee's address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Attendee's phone number (provide the best number for use over your travel dates) *

Area Code Phone Number
Attendee's email *
Emergency contact name *

First Name Middle Initial Last Name
Emergency contact phone number *

Area Code Phone Number
Will you need air/train travel arrangements? *

yes, see Amex GBT instructions from staff liaison no, I will arrange my own travel
If you require assistance please note the ASA is now booking through American Express Global Business Travel (GBT). Please see the GBT instructions sent from your ASA staff liaison.
All those traveling on behalf of the ASA should secure the lowest-priced, coach class, nonrefundable tickets for approved trips.
Will you need a hotel reservation? *

yes no
Hotel date(s) if different from event dates
Hotel preferences

Single Occupancy Double Occupancy Smoking Non-smoking Late check-in ADA accessible
What are your meal preferences? *

beef chicken seafood vegetarian
Do you have any food allergies? *

yes no
Please select *

dairy gluten/wheat nuts seafood other
Allergy details *
Should be Empty: