Spring 2016 Registration Form

April 17–20, 2016
The Fairmont Washington, D.C., Georgetown

Please complete this form to be added to the waiting list.

For additional information or questions, please email kstevens@q-group.org. Seminar papers will be available for download on the Spring 2016 Seminar page as they become available.

Full Name ^*

^*required

Is this your first attendance at a Q Group Seminar?

YesNo

Nickname for badge ^*

Title ^*

Firm or Affiliation Name ^*

Street Address ^*

City ^*

State ^*

Zip or Postal Code ^*

Country ^*

Business Telephone ^*

Cell Phone ^*

Email ^*

Will Your Spouse/Guest be Attending?

YesNo

Name for Badge Spouse/Guest

Home City & State for Spouse/Guest

Will you be staying at the Fairmont Washington D.C. Georgetown?

YesNo

If NO, what is the name of the hotel where you will be staying?

Will you be attending the following reception/dinners?

Sunday evening

YesNo

Monday evening

YesNo

Tuesday evening

YesNo

 

Thank You!