LIA State Exchange - New England Interest Form

Participant Interest Form

Please fill out this form in its entirety.
Space is extremely limited on this trip. The LIA Alumni Activities Committee will select participants for the State Exchange.
LIA Alumni Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Guest Information

First NameLast Name
Guest Email
example@example.com
Guest Phone Number
Format: (000) 000-0000.
Relationship to LIA Alumni
Is your guest also LIA Alumni?
Guest Phone Number
Format: (000) 000-0000.
Guest E-mail
example@example.com
Please explain in a couple sentences why you would like to attend this State Exchange:
Please Note: We will be flying into Boston, MA, on Saturday, September 26th and departing from New York (LaGuardia), NY, on Friday, October 2nd.
We will be exploring the option of a Group Travel rate out of Boise with Delta Airlines. Would you be interested in be a part of this group rate?
Would you like assistance making travel arrangements?
Please do not make travel arrangements until your attendance is confirmed.
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:
Pricing: $2,450/participant

(Based on double occupancy)

If you are selected, a non-refundable $500 deposit per participant will be required to hold your spot and will be applied toward the total cost.
Are you requesting scholarship assistance from the LIA Foundation?
(Requests for scholarship assistance will be considered by the LIA Board of Trustees). Scholarship Assistance is not guaranteed and is only available to LIA Alumni.
Please click the "Submit" button below to submit your interest.
Should be Empty:

Participant Interest Form