LIA DC Experience Interest

DC Experience Interest Form

May 3-8, 2026
LIA Alumni Contact*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guest Information

First NameLast Name
Relationship to LIA Alumni
Is your guest also LIA Alumni?

YesNo
Guest Phone Number
Guest E-mail
example@example.com
Would you like assistance making travel arrangements?

YesNo
Do you have any dietary restrictions or physical limitations that need to be accounted for in the planning of this trip? Please explain in detail:
Are you requesting scholarship assistance from the LIA Foundation? *
(Requests for scholarship assistance will be considered by the LIA Board of Trustees in September). Scholarship Assistance is not guaranteed and is only available to LIA Alumni.

NO NEED TO FILL OUT THE PAYMENT INFORMATION AT THIS TIME; THIS IS AN INTEREST FORM ONLY AND DETAILS AND COSTS ARE BEING FINALIZED.

Credit Card Payment for:

Deposit (per Participant)Applied toward Total

$500.00 Quantity

Full Payment - Alumni

$1,750.00 Quantity

Full Payment - Guest

$1,250.00 Quantity

Please Invoice Me for:

Deposit per Participant ($500)Applied toward Total

$ Free Quantity

Full Payment - Alumni ($1,750)

$ Free Quantity

Full Payment - Guest ($1,250)

$ Free

Subtotal

$0.00

Tax

$0.00

Total

$0.00

DC Experience Interest Form