2019 Annual Program Review Registration

Please complete this form to register for the 2019 annual program review and related activities. Once submitted, you will receive an automated e-mail confirmation. Please contact us if you have any questions. Thank you!

Personal Information
How would you like your FIRST name to appear on your badge?
Valid e-mail address (confirmation will be sent to this address).
Emergency Contact
Who should we call in case of an emergency?
Supplementary Information
If you selected 'Other', please explain.
Planned Attendance

I will attend the following:

Wednesday, June 26
Thursday, June 27
Hotel Reservation

Please complete this section ONLY if you require a hotel reservation.

The Krell Institute has reserved a block of rooms at the Capital Hilton Hotel for attendees at a special rate. To reserve a room within the Krell Institute block, check the box below and enter the requested information. Rooms will be guaranteed/direct billed to Krell's master account, however, guests will be asked to supply a credit card upon check in to cover incidentals.

What type of room would you like?

A special note for federal employees: A limited number of government rate rooms have been reserved. Federal government employees planning to pay for their own accommodations should contact us for more details.

Hilton Honors members may opt to pay for their rooms and accumulate points for their stay. If a valid Hilton Honors number is provided below, it will be submitted to the hotel and a credit card will be required at check-in. Lodging and incidental charges will be billed to the card and will earn Hilton Honors points.

Special Needs

Let us know how we can assist you. Please be as specific as possible.

Do you have any special health needs?
Do you have any special dietary needs?
Do you have any special room needs?
Are there any other needs we should be aware of?
Presentation Information

Please complete this section ONLY if you are a presenter.

Krell recommends that you make use of the provided equipment since the presentations will be recorded, but if you have special requirements for your presentation and need to use your own, please indicate this below and provide more details in the comments section.

Which presentation software will you need?

Does your presentation have audio?

Does your presentation have a movie? (Please provide the format and resolution of your movie in the comment box below.)

The Krell Institute will make audio and video of your presentation available on the Internet following the event, but only with your express permission. Can your presentation be released?

Are there special items needed for your presentation?
Additional Comments
DOE Office of ScienceNNSAKrell Institute