ACIS Staff GC Registration

Fields marked with an * are required

Global Conference *

Departure Date (Staff departs at least one day before GLs) *

Return Date (Staff departs same day as GLs) *

Group ID (If you have one)

If you don't have a group ID, you will be a fellow staff member's companion. Please enter their GL ID and Name.

Personal Information

First Name *

Middle Name

Last Name *

Street Address #1 *

Street Address #2

City *

State *

Zip Code *

Gender *

Birthdate (MM/DD/YYYY) *

Email *

Phone Number *

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