NASPVA Attendee Information Form

Attendee Information Form

Instructions:

Please complete a separate form for each attendee. This information will be used for event planning, name badges and directory entries.

This is an information only form, not the conference registration. To secure a spot at the conference, you must complete the payment process.

There are 2 steps to complete to attend the conference:

1) Attendee Information Form - completed by submitting this form.

2) Attendee Registration Payment - after completeing this form, visit the payment link provided in your confirmation or on the NASPVA Site.
Attendee Information

Fill out the form for each conference attendee. Guest information can be added below and does not require a separate form.
Would you like to add your photo for the conference directory?
Attendee Name*

First NameLast Name
Email Address for Conference Communications*
example@example.com
Main Contact Cell Phone Number*
We will use this as the first contact if needed during travel and while you are on site. Format: (000) 000-0000.
Backup Cell Phone Number
If you have a secondary phone with you, i.e. a personal cell phone in addition to a work phone, we will use this as a second contact if needed.Format: (000) 000-0000.
Guest Information

Reminders for guests: Transportation provided for the conference is for registrants only. Guests are included in the evening meals only.
NOYES
Yes, I understand that I need to complete registration payment including the guest fee of $115.00.
Guest Name

First NameLast Name
Emergency Contact Information
Emergency Contact *

RelationshipFirst NameLast Name
Emergency Contact Phone Number*
Enter a valid phone number for emergency contact. Format: (000) 000-0000.
Dietary Information
Gluten FreeDairy FreeVegetarianVegan
YesNo
If yes, please describe them below.*
Accommodations
YesNo
Please list any accommodations that may be necessary to fully participate in all conference activities.*
The next section will provide information on transportation, lodging and registration fees. You will need to visit the NASPVA Site for links and additional information to complete your registration payment and travel logistics.
Transportation Information
Conference shuttles will be provided from the Eugene Airport (EUG) to the Hallmark Resort Newport and back. Shuttle service is not offered to/from the Portland International Airport. Reservations are required for this service; this form is not a reservation but will add you to our list to contact regarding shuttle services. Choose yes below if you will need conference provided transportation between the Eugene Airport and the Hallmark Resort Newport.*

YesNo
Shuttle service will only be provided to and from the Eugene Airport (EUG). Conference shuttle service is not offered to/from the Portland International Airport (PDX). Transportation is for conference registrants only, this does not include guests.

Shuttles will be available on Monday, October 19 for arrivals and Friday, October 24 for departures, at varying times. You will be contacted directly to reserve your shuttle time.
Lodging
Yes, I understand that I need to make my own lodging arrangements at the Hallmark Resort Newport.
Registration
Yes, I understand that I need to complete payment to reserve my spot at the conference.
Click Submit below before visiting the NASPVA site. Links will be provided on the confirmation page for conference payment and the NASPVA site.

We look forward to seeing you on the beautiful Oregon coast!
Should be Empty:

Attendee Information

Guest Information

Emergency Contact Information

Dietary Information

Accommodations

Transportation Information

Lodging

Registration