REGISTRATION FORM

Dates: Oct. 1st – 4th, 2018

Note: All participants should plan to arrive to attend a Briefing Session to be held Tuesday 10-2 at 4:00 PM prior to dinners.

Participants will be responsible for their other meals, travel and hotel accommodations and reservations. Click here to use our hotel block code to add https://book.passkey.com/go/MDSA2018.

Contact: Jessica Gregg

Email: mdss@mcalester.org

Phone: (918) 423-2550

DEADLINE FOR RESERVATIONS and FEE: September 10th, 2018

Note: Bio’s for Registrants will be requested as a courtesy to VIP’s attending from Washington. Likewise MDSA will furnish to Stampede participants the Bio’s for VIP’s who have confirmed attendance. A planning and briefing session will be held to discuss Talking Points and names of VIP’s.

Name*
First Last
Representing:*
- Self
- Business
Business Name*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Registration Fee*
- Self Registration
- Self Registration + Spouse
Spouse's Name*
Payment*
- Pay Now via PayPal / Credit Card
- Please Invoice Me
Total
$0.00