Application Name* First Last Suffix Legislative Title*I am a:* Legislator Newly Elected Legislator Legislative Staff Partner Organization Other: Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Legislative Email* Enter Email Confirm Email Preferred Email (only if different from legislative email) Enter Email Confirm Email Phone number where you can be reached for conference questions*Phone typemobilehomeofficeHotel:For people traveling from out of town, SiX is able to provide hotel accommodations for the nights of December 2nd and December 3rd. You are responsible for making your own hotel reservations by October 26, 2018. Upon successful registration for the conference we will send you an Omni Shoreham Hotel web registration link. Do you need Hotel Accommodations?* Yes No Please indicate which night(s) you need lodging for: December 2nd December 3rd No hotel needed Travel Scholarship:Limited scholarship dollars are available, please only apply for a scholarship if you would be unable to otherwise attend the conference. Due to heightened demand and limited availability, SiX cannot guarantee travel scholarship to legislators attending the conference. Scholarships up to $200 will be awarded to a limited number of legislators. To be eligible for a scholarship you must register for the conference by October 1.Do you want to apply for a travel scholarship? (Applying for a travel scholarship does NOT guarantee you will receive a scholarship.)*Please only apply if you would be unable to otherwise attend the conference. Yes No Please estimate your travel cost*Round trip air Why do you want to attend the SiX conference?*What kind of training and/or policy briefing topics are you interested in learning more about and attending?*I affirm that I am not under any indictments, accusations or investigations for any criminal behavior, sexual harassment claims or campaign finance violations.* I affirm I am confirming there is a registration fee to attend the SiX Conference . Upon award of scholarship, I will be asked to pay a early bird registration fee of $95 by September 1, 2018 or $150 after September 1st.* Yes, if approved I will register and pay $95 by September 1st GDPR Regulations require us to obtain your agreement with the storage and handling of your data by our website. Check to agree.*Your data is used for the purpose of the conference and registration. SiX will not share any of your information. I agree to the storage of my data.