Joint Conference & PD Registration Form

Joint Conference and Professional Development Registration Form
- Use this form to register for all conference activities and JPD. No additional registration is required.
- Professional Development is in a paid military status pending approval.
- Those attending Professional Development in a paid military status are required to attend all PD sessions in duty uniform.
- Lodging / DTS reimburseable for those on orders outside of 50 miles through assigned unit.
Full Name*

First NameLast Name
Rank*
Branch*
Unit
Civilian Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Association Membership (Membership is not required to attend)
Other State Membership
Do you or your Guest(s) have any dietary or accessibility requirements?
Guest 1 Name

First NameLast Name
Guest 2 Name

First NameLast Name
Child 1 for Friday Evening Childcare (Childcare is provided at no cost)

First NameLast Name
Child 1 Age
Child 2 for Friday Evening Childcare

First NameLast Name
Child 2 Age
Child 3 for Friday Evening Childcare

First NameLast Name
Child 3 Age
Child 4 for Friday Evening Childcare

First NameLast Name
Child 4 Age
YesNo
YesNo
Golf Team Player 1
Golf Team Player 2
Golf Team Player 3
Golf Team Name

My Products - Select all that apply.*

Joint Conference & Professional Development E6, WO2, O3 and below

Friday Social, Awards Gala, Hospitality Night, Association Business Meeting, Industry Partner Exhibits, and JPD

$90.00 Quantity

Joint Conference & Professional Development E7, WO3, O4 and above

Friday Social, Awards Gala, Hospitality Night, Association Business Meeting, Industry Partner Exhibits, and JPD

$110.00 Quantity

NGAKS/EANGKS Joint Conference Retirees and Guests

Friday Social, Awards Gala, Hospitality Night, Association Business Meeting, Industry Partner Exhibits

$40.00 Quantity

Golf Tournament - March 26 - Trails West, Ft Leavenworth

Three-man teams with fourth player being an Industry Partner Representative

$60.00 Quantity

Total

$0.00

Joint Conference and Professional Development Registration Form