ACG 2nd Year Fellows Course Travel Form - American College of Gastroenterology

Congratulations on being selected to attend the ACG 2nd Year Fellows Course. Please fill out the form below and we will be in touch regarding your arrangements.

If you have any questions, please email Stephanie

Contact Information

Name (as it appears on your Government ID)(Required)

First Middle Last

Email(Required)

Mobile Phone #(Required)

Attendee Confirmation(Required)

I agree to comply with all of the parameters outlined below.

Each attendee must commit to participate for the entire program. Participants must arrive at the hotel in time for the 7:00 pm opening dinner session on Friday, January 17th and depart no earlier than 11:30 am on Sunday, January 19th (departure flights will be scheduled for 1:00 pm or later). This course is a three-day working conference with very little free time, and trainees agree to attend all sessions and meal functions. As this course is designed not only as a learning opportunity, but also to help attendees build relationships among their peers, you are expected to attend the course alone and not be accompanied by family members or guests. In order to confirm your commitment to the program, please check the box above. If you have any questions or require further information, please feel free to contact Stephanie at sayala@gi.org or 240-858-8337.

Travel Arrangements

Please make my reservation as follows(Required)

Airline

Train

I live within 300 miles of the DC area and will drive (enter your city below and put N/A in the Time of Day, Seat Preference and Date of Birth Fields)

Departure City(Required)

Preferred or Closest Airport or Train Station

Time of day you can depart(Required)

Indicate time of day you can depart on Friday, January 17.

Seat Preference(Required)

Gender(Required)

Female

Male

Date of Birth(Required)

Known Traveler ID # (TSA Precheck or Global Entry)

Dietary Restrictions

Please indicate any food allergies or dietary restrictions.

Notes/Comments

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