ADC National Convention 2015: State Department Briefing Registration
Please note that registration for the State Department Briefing Closed on Monday, June 8, 2015.

This form is for ADC National Convention 2015 attendees to register to attend a briefing at the U.S. Department of State on Thursday June 11, 2015, the first day of the 2015 ADC National Convention. The briefing will take place at the State Department from 1:00PM to 4:00PM.  

Space at the State Department briefing is limited, and spots will be given to ADC Convention registrants on a first come basis.  Please note that only ADC Convention registrants who complete this form by Monday June 8th 2015 will be permitted to attend the briefing.

For security purposes, attendees of the briefing must provide the following information to the State Department in advance and bring a current U.S. government issued identification to the briefing.
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First Name
Please enter your name exactly as it appears on U.S. government issued identification that you will bring to the State Department Briefing (Driver's License, Passport, etc.)
Middle Name
Please enter your name exactly as it appears on U.S. government issued identification that you will bring to the State Department Briefing (Driver's License, Passport, etc.)
Last Name
Please enter your name exactly as it appears on U.S. government issued identification that you will bring to the State Department Briefing (Driver's License, Passport, etc.)
Email
Phone Number
Driver's License Number AND State of Issuance
(If no driver's license then provide passport number in the next question)
Passport Number and Country of Issuance
(Only required for non U.S. Citizens and those without a U.S. driver's license)
Date of Birth
(Only required for non U.S. Citizens)
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