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NCS Capitol Hill Connection Registration
Nick Viano
2023-09-25T10:30:57-05:00
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Capitol Hill Connection Registration
Your name as show on Government ID
(Required)
First
Last
Email
(Required)
Phone
(Required)
Title
Organization
Do you have any dietary restrictions?
(Required)
Yes
No
List your restrictions
Hotel Arrangements
(Required)
Staying with Group in Hotel Block ($1500)
Staying on my own ($1000)
Other
Staff & Sponsor Code
Total
Credit Card
Cardholder Name
Card Details
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