Dinner

Registration

Important information:

NYC regulations require proof of vaccination for COVID-19 and identification for all attendees.

    First Name*

    Last Name*

    Title*

    Organization*

    Email Address*

    Phone Number - Office *

    Phone Number - Cell *

    Do you have an executive assistant?*

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    Executive Assistant Name*

    Executive Assistant Email*

    Executive Assistant Telephone*

    [/group]

    Are you a University of Pennsylvania Alumnus?*

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    What is your alumni designation (e.g. WG68 or C99)*

    [/group]

    * Required Fields