2024 Auxiliary/National Home Jr. Vice Registration

Personal Information

First Name *

Last Name *

Title *

Nickname

Address *

City *

State *

Zip code *

Email *

Please confirm email *

Day Phone *

Which Department do you represent? *

Travel Information

Are you flying or driving? *

Driving

Flying (Flight information is required to continue registering))

Arrival

Airport *

Airline

Arrival +

Time

MI Flyer leaves terminal

Departure

Airport *

Airline

Departure +

Time

MI Flyer leaves East Lansing Marriott

Hotel Information

Hotel Room Preference *

1 King Bed @ $85 night plus tax

2 Queen Beds @ $85 night plus tax

No accommodations are needed

Note: The hotel will do its best to accommodate your room type but may not have your choice available by the time you check-in.

Do you need a hotel room reserved for:

Wednesday May 15th *

Yes

No

Thursday May 16th *

Yes

No

Friday May 17th *

Yes

No

Saturday May 18th *

Yes

No

Sunday May 19th *

Yes

No

DoubleTree confirmation #

I authorize Auxiliary Headquarters to make my hotel reservation at the DoubleTree Hotel Lansing at the Capitol. I understand that I am responsible for hotel room fees and must provide a credit card at check-in.

Consent to make hotel reservation

Guest Information

I plan to bring a guest *

Yes

No

Your Guest's First Name *

Guest's Last Name *

What is your relationship to your Guest?

Special Needs

My guest or I have mobility limitations (wheelchair or walker use, unable to use steps, ect.))

Please explain your needs: *

My guest or I have other special needs (dietary, other health concerns, etc)

Please explain your needs: *

Emergency Contact Information

Emergency Contact 1

First Name *

Last Name *

Relationship to Attendee *

Phone Number *

Emergency Contact 2

First Name

Last Name

Relationship to Attendee

Phone Number

Spouse	Dept. Commander
Dept. President	Dept. Sr. Vice Commander
Dept. Sr. Vice President	Dept. National Home Chairman
Dept. Veteran & Family Support Chairman	Other Other