Smart Cities Innovation Accelerator at Las Vegas

Please fill out the information below to apply. All fields marked * are required.  Information will be used directly for event program and logistics updates, so please do fill our all the required boxes!

Registration Day

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* 1. What day are you registering for?

USER DETAILS

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* 2. First Name

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* 3. Last Name

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* 4. Biography

Please enter 50-150 word bio of yourself. This will appear *verbatim* in the program.

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* 5. Email - This will be used to contact you for updates of the event.

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* 6. Title

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* 7. Organization

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* 8. Street

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* 9. City

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* 10. State

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* 11. Zip Code

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* 12. Country

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* 13. Phone

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* 14. Dietary restrictions or allergies

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* 15. Headshot for printed program and photo roster

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APPLICATION FOR TRAVEL SUPPORT
Travel support for up to 2 nights' hotel and coach airfare will be provided for city CIOs (or equivalent), plus one senior official from the city - while funding lasts.  All other travel expenses are the responsibility of the traveler/city.  Additional city attendees are welcome to attend at their city's own expense.  (Travelers outside of N. America: travel support can include 3 nights' hotel and may also cover a portion of the flight expenses - to be considered on a case-by-case basis).

IMPORTANT:  If your city can support your travel, please do not request travel support. We may not be able to support all applicants and would like to be as inclusive as possible.

All travel must be booked by December 14th - no late travel reservations will be permitted.

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* 16. DISCLAIMER:  Travel support is paid and booked directly by the event organizer, The Innovators Forum, LLC.  The Accelerators are supported in whole or part by sponsorships and in-kind support from host cities. Meals are provided during the event (valued at approximately US$250). At some events, travel support is provided to assist attendees who may not have travel funds to attend. Travel is valued at the actual amount of the flight and hotel. Travel and meals are paid for by The Innovators Forum, LLC using the proceeds from registration and/or sponsorship.

If your city requires any additional information for you to accept travel support or to register, please email.

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* 17. I am requesting travel support because my city/organization is not able to support my travel. We ask those cities who can support travel to please do so, as we will not be able to support all requests. Having your city support your travel will allow other cities to attend, who do not have the means for travel support.

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* 18. I am employed by the city, or my employer is wholly owned by the city and I wish to apply for travel support.

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* 19. Name of second person attending from your city (they should register separately also). If three are attending, simply enter one name to confirm eligibility.

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* 20. Name as it appears on your government ID (for travel purposes).

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* 21. In the case that I decide or am unable to attend, I agree to reimburse the event organization for any non-refundable travel expenses incurred.

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* 22. Are there any special travel requirements we should know about? Seating will be chosen by you through the carrier directly after booking the flight. This will allow you to select and upgrade your seat if you choose. We typically book the lowest coach airfare with a maximum of 1 layover. If several routes are similarly priced, we will provide the traveler with options.

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* 23. Airport traveling from (three letter code).

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* 24. Date of birth (will be held confidential, but required to book flights).

Date / Time

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* 25. Male or Female (required to book flights)

ADMIN DETAILS
We will be happy to work directly with your admin on logistics and even updates if you provide their information. 

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* 26. Admin's Name

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* 27. Admin's Title

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* 28. Admin's Email

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* 29. Admin's Phone

MEDIA CONTACT INFORMATION
As our events engage senior leaders, we are sometimes contacted by press who are interested in contacting attendees for their perspective and thoughts on the event topic. We keep your contact information confidential and do not share it with the media; however, if you would like to be contacted, you may opt-in by typing YES in this box. Leaving it blank or typing NO will let us know not to share your information.

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* 30. Share Contact?

LINKS (PR for you/your city - optional)
These may be used on the dissemination website as resources for other attendees and the general public.

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* 31. Link 1

Please enter a link to your website or other online collateral.

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* 32. Link 2

Please enter a link to your website or other online collateral.

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* 33. YouTube/Vimeo Link 1

Please enter a link to any videos you would like to share with other participants.

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* 34. YouTube/Vimeo Link 2

Please enter a link to any videos you would like to share with other participants.

Thank you for completing the application. Please click the DONE button below. We will review your application and let you know our decision soon.

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