Registration Form - The Israel Lobby: Is It Good For The US?

Conference Registration Form
National Press Club Ballroom
April 10, 2015 8AM-5PM
Same day registration is $199
Fax to: (202) 265-4574
Email to: [email protected]
Mail to: 2015 Conference, PO Box 32041, Washington, DC 20007
Registrant Information (Please check only one per form)
$75 special rate. My registration will
be sent or postmarked on or before
3/31/2015. Please send my ticket
confirmation to the email below. I
understand seating is limited and
agree to abide by National Press
Club and conference rules.
$100 standard rate. My registration will
be delivered on or before 4/8/2015.
Please send my ticket confirmation to
the email below. I understand seating is
limited and agree to abide by National
Press Club and conference rules.
*First Name
I am a currently enrolled student in an
accredited college or university and am
applying for a zero-cost student ticket
and lunch. I understand seating is
limited and that my ticket, if granted,
will be sent via email. I agree to abide
by National Press Club and conference rules.
*Last Name
I am a member of the news media and
apply for a credential allowing full access
to the event and a complimentary lunch. I
understand space is limited and that if
granted my press credential confirmation
will be sent via email. I agree to abide by
National Press Club and conference rules.
Salutation (Mr. Mrs. Dr. Ms. Miss. Etc)
*Name as you wish it to appear on your badge; please include any title or organizational affiliation which may be applicable
*Address
*City
*State
Business Phone
*Zip
*Email
Mobile Phone
Home Phone
Payment Information
Amex
Visa
Credit Card#
**Name as it appears on Card
MasterCard
Check (enclosed) to AET or IRmep with “2015 conference” in memo line.
**Expiration Date
**Security Code
**Signature
**Billing address associated with credit card, if different than above, and card–related phone number
**Required registration information
**Required payment card information
Rev. 1/1/2015
Registration, Refund Policy, National Press Club and Conference Rules
The registration desk for gaining entry to this event opens promptly at 8 AM on April 10, 2015. Attendees may be asked to present a government-issued photo ID in order to receive their entry badge. The entry badge must be worn by attendees at all times while inside the National
Press Club. Requests for refunds must be received by April 1, 2014. No refunds will be issued after that date. Only the official videographer
and accredited, pre-registered members of the press will be allowed to audio or video record this event. Live webcasting is prohibited by the
National Press Club. No outside food or beverage items are allowed into the ballroom. Attendees will be asked to coat-check any suitcases,
large backpacks or other similarly bulky items before entry into the ballroom. No public dissemination of third-party information in conjunction with or during the conference is permitted without the express prior written permission of the organizers one month in advance. Individuals or organizations that violate these National Press Club or conference rules or disrupt orderly proceedings may have their conference credentials revoked, and may not be permitted to participate in future events.
Location
The National Press Club building is located at 529 14th St. NW, Washington DC, 20045
The Ballroom is located on the 13th floor. Elevator banks are located at the 14th St. entry.
Nearby metro stops within three to four blocks include Metro Center (Blue, Orange and Red lines), McPherson Square (Blue and Orange
lines) and Federal Triangle (Blue and Orange lines).
Event Updates
Get official event updates from the web at: http://www.IsraelLobbyUS.org
Receive official event updates via Twitter by following @IsraelLobbyUS
Organizers
Rev. 12/27/2014