26.DoH Reg Form

Thank you for joining us on the Hill! Please complete the information below for the 2026 Day on the Hill.

If you have multiple attendees, please have each person register separately so we have accurate counts and can schedule Hill meetings.
Name*

First NameLast Name
Company*
Email*
Cell Phone*
Please enter the Congressperson or District for the address where your BUSINESS is located. (If you do not know, please enter your Business address and we will look it up for you) *
Congressperson OR Business Address (City, State, and Zip Code ONLY)
Please enter Congressperson or District for the address where your HOME is located. If same as business, just type "Same" (If you do not know, please enter your HOME address and we will look up your Congressional representative. You can also Google this information if you prefer)*
Congressperson OR Home Address (City, State, and Zip Code ONLY)
Events for Tuesday, April 14
Will you attend lunch and the the guest speakers/educational sessions beginning at approximately 1:00PM?*

YesNo
Events for Wednesday, April 15
Will you attend meetings with your Congressional Representatives on the Hill?*

YesNo

Dinner Payment Form - All Guests Must Pay Prior to the Event (Leave Blank if NOT Attending Either Dinner)

Tuesday Evening Dinner$210.00

Includes dinner and open bar. Located at La Vie on the District Wharf - 7:00pm - 9:00pm

Quantity

Wednesday Evening Dinner$210.00

Includes dinner and open bar. Located at The Grill on the District Wharf - 6:30pm - 8:30pm

Quantity

Day on the Hill Premier Sponsorship$2,500.00

Day on the Hill Supporting Sponsor$1,000.00

Enter coupon

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Thank you for joining us on the Hill! Please complete the information below for the 2026 Day on the Hill.