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* 1. Your Name (What you want on your name tag)

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* 2. City / County

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* 3. Contact Information

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* 4. On Wednesday, November 5th, starting at 1:45 pm, there will be a choice of two field trips. Please indicate which field trip you will participate in by checking one box.

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* 5. Registrants are expected to participate in all activities unless there are unavoidable schedule conflicts. Please select all of the activities you plan to take part in.

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* 6. A block of rooms has been reserved at the Aloft hotel. The government rate for a room is $138 per night ($275 for 2 nights). Please indicate which nights you will require lodging. Extra nights must be reserved independently.

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* 7. Please indicate whether you have any special requests (ie dietary needs, accessibility, etc.)

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* 8. Because the annual meeting keeps us connected, SSDN strives to keep meeting costs affordable for members. However, we ask that members cover one or more of the following costs, and if there is a second city participant, to cover all expenses for that person. The suite of options is designed for you to be able to choose whatever combination works best with your budget:

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* 9. What are you hoping to gain from your participation in the SSDN annual meeting?

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* 10. The draft meeting agenda is included in the email that contains the link to this survey.  Speakers are still being identified.  If you are interested in speaking on a topic, have any questions, comments, or would like to be contacted specifically about this event, please indicate below.

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