2024 NLA Day on the Hill Registration Form

Please complete the information below for the 2024 Day on the Hill.
Name

First NameLast Name
Company
Email
Business Address (City, State and Zip ONLY)
Home Address (City, State and Zip ONLY)
Cell Phone
Events for Tuesday, May 14th
Will you attend lunch and the the guest speakers/educational sessions beginning at approximately 1:30PM?
Will you attend the NLA Board/PAC Fundraiser Dinner from 6:30 - 8:30 PM at La Vie in the District Wharf? ($195 fee per person, includes dinner and open bar.)
Including yourself, how many for the PAC Fundraiser Dinner?
Guest Names (if applicable)
Events for Wednesday, May 15th
Will you attend meetings with your Congressional Representatives on the Hill?
Will you attend the Day on the Hill Dinner from 6-8 PM at Hank's Oyster Bar at the District Wharf? ($195 fee per person, includes dinner and open bar)
Including yourself, how many for the Day on the Hill Dinner?
Guest Names (if applicable)

Tuesday Board/PAC Dinner at La Vie$195.00

Quantity

Wednesday Day on the Hill Dinner at Hanks Oyster Bar$195.00

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

Please complete the information below for the 2024 Day on the Hill.