2016 Congressional Leadership Conference

ACOG’s 2016 Congressional Leadership Conference (CLC), the President’s Conference, allows ob-gyns like you to build and maintain lasting relationships with your U.S. Senator or Representative, making YOU our most important asset on Capitol Hill.

Join your colleagues at ACOG’s popular advocacy event in Washington, DC, March 6-8, 2016.

Omni Shoreham Hotel, Washington, DC

Question Title

* 1. Please fill out your contact information below. We require both your home and work addresses for your Congressional appointment scheduling, as well as your cell phone number so that we can contact you if your Congressional appointments should change.

*Please do not contact any legislative office directly regarding your appointments. We are coordinating a large number of meetings and want to keep confusion to a minimum. We are happy to answer any questions or concerns you might have regarding your meetings once you arrive in DC.

Name: *

Home Address: *

Address 2:

Home City/Town: *

Home State: *

Home ZIP: *

Home Country:

Email Address: *

Cell Phone Number: *

Question Title

* 2. Work information:

Work Address: *

Address 2:

Work City/Town: *

Work State: *

Work ZIP: *

Country: