2023 ACD 37th Quadrennial Convention Registration Step 1 of 4 25% HiddenFamily Guest CountHiddenAdditional Guest CountAre you completing this form on behalf of someone else?If you are completing this form on behalf of another person, we would like to collect your contact information in the event we need to get in touch.If you are registering yourself, then you may skip this step.YesNo, skip this stepYour Name First Last Your Email Address Your Phone NumberRegistrant DetailsHiddenAttendee Type Name(Required) First Last Mobile Phone(Required)*VERY IMPORTANT*: All convention upates and changes will be sent to you via text message to this phone number. Please be sure you can receive text messages on this number. Data and messaging rates may apply, and you may opt out at any time.Office PhoneWhat is your role(Required)Please SelectDelegateStaffInvited GuestEmail(Required) Enter Email Confirm Email Name on Badge (First & Last Name)(Required) Job Title(Required) ACD Represented Entity(Required)Please SelectLocal 1, ILALocal 1000, ILALocal 1037, ILALocal 1066, ILALocal 1233, ILALocal 1235, ILALocal 1242, ILALocal 1248, ILALocal 1259, ILALocal 1286, ILALocal 1291, ILALocal 1294, ILALocal 1317, ILALocal 1329, ILALocal 1341, ILALocal 1411, ILALocal 1413, ILALocal 1429, ILALocal 1433, ILALocal 1478-2, ILALocal 1518, ILALocal 153, ILALocal 1566, ILALocal 1570-A, ILALocal 1588, ILALocal 1604, ILALocal 1624, ILALocal 1652, ILALocal 1654, ILALocal 1657, ILALocal 1694, ILALocal 1730, ILALocal 1740, ILALocal 1768, ILALocal 1804-1, ILALocal 1809, ILALocal 1814, ILALocal 1825, ILALocal 1842, ILALocal 1843, ILALocal 1867, ILALocal 1883, ILALocal 1884, ILALocal 1903, ILALocal 1904, ILALocal 1908, ILALocal 1909, ILALocal 1913, ILALocal 1947, ILALocal 1949, ILALocal 1953, ILALocal 1963, ILALocal 1964-A, ILALocal 1964-B, ILALocal 1969, ILALocal 1970, ILALocal 1975, ILALocal 1976, ILALocal 1982, ILALocal 1996-1, ILALocal 1997, ILALocal 2000, ILALocal 2001, ILALocal 2007, ILALocal 2008, ILALocal 2012, ILALocal 2013, ILALocal 2020, ILALocal 2028, ILALocal 2033, ILALocal 2038, ILALocal 2048, ILALocal 2049, ILALocal 2052, ILALocal 2059, ILALocal 2064, ILALocal 2065, ILALocal 2068, ILALocal 2070, ILALocal 2071, ILALocal 2076, ILALocal 217-A, ILALocal 269, ILALocal 273, ILALocal 3, ILALocal 333, ILALocal 342, UMD, ILALocal 350, UMD, ILALocal 479, ILALocal 799, ILALocal 800, ILALocal 805, ILALocal 809, ILALocal 815, ILALocal 824, ILALocal 861, ILALocal 920, ILALocal 953, ILALocal 970, ILALocal 976, ILAOther, not listedPlease add your ACD Represented Entity Primary Contact Details (continued)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Emergency Contact Name(Required) Emergency Contact Phone Number(Required)What size convention shirt would you like?(Required)Please SelectMediumLargeX-LargeXX-LargeXXX-Large (Limited availability)I do not want a shirt Below, please see the tentative schedule of events for the convention. Please read through the schedule carefully and indicate your attendance plans for the events listed below.Confirming your attendance plans for the convention special events in advance allows us to plan accordingly to ensure everyone's enjoyment at each event.Please note: Badges must be worn by ALL attendees for admittance into the special events. This schedule is subject to change.Convention Event ScheduleTuesday, July 18, 2023 7:00 am Coffee served 9:00 am Call to Order 1:00 pm Lunch 6:00 pm Welcome Cocktail Reception and Dinner Will you attend the Welcome Cocktail Reception and Dinner?(Required)Please SelectYesNoNot SureWednesday, July 19, 2023 8:00 am Coffee served 9:30 am Call to Order 1:00 pm Lunch 6:30 pm pm Gala Cocktail Reception 8:00 pm Gala Dinner Will you attend the Gala Dinner?(Required)Please SelectYesNoNot SureThursday, July 20, 2023 8:30 am Coffee served 10:00 am Call to Order 6:00 pm Pool Party Will you attend the Pool Party?(Required)Please SelectYesNoNot Sure Guest RegistrationPlease skip to the next page if you will not be bringing guests.You are welcome to bring up to five guests for a total of six people including yourself. If you plan to bring more than 5 guests, you will need to request approval using the "Additional Guests" form below.Please include the first name and last name of your guests as this is how their names will appear on their guest badges. All guests must be registered prior to the convention. Unregistered guests will not be allowed in any ILA meetings or events.Guest Details Guest Name Age July 18: Welcome Reception/Dinner July 19: Gala Dinner July 20: Pool Party Actions Edit Delete There are no Guests. Add Guest Maximum number of guests reached. HiddenAdditional GuestsAttendees are allowed to invite up to five guests without approval. If you would like to request approval for additional guests, please add them below. Do you wish to request approval for guests in addition to those you added above?NoYesAdditional Guest Request Attendees are allowed to invite up to five guests without approval. If you would like to request approval for additional guests, please add them below.I am requesting to have the following additional guests attend the 37th Quadrennial ACD convention with me at the Diplomat Beach Resort in Hollywood, Florida July 17-20, 2023. I understand that this request to bring additional guests is subject to approval by the ACD, and is not guaranteed. The ACD will provide an update on this request as soon as possible. Please include the first name and last name of each additional guest as this is how their names will appear on their guest badges if their registration is approved.Additional Guests Guest Name Relationship to Delegate July 18: Welcome Cocktail Reception and Dinner July 19: Gala Dinner July 20: Pool Party Actions Edit Delete There are no Guests. Add Guest Maximum number of guests reached. CommentsThis field is for validation purposes and should be left unchanged.