Wufoo
DDP Meeting Registration
Please Register Below for 2013 DDP Meeting.
Name
*
First
Last
Degree (if applicable and you want it listed on your namebadge)
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
----
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
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Antarctica
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Argentina
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Aruba
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Belize
Benin
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Bolivia
Bosnia and Herzegovina
Botswana
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
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Cameroon
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Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
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Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Gabon
Gambia
Georgia
Germany
Ghana
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Guinea
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Guyana
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Hungary
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Iran
Iraq
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Israel
Italy
Jamaica
Japan
Jordan
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Kenya
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North Korea
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Kuwait
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Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Email Address
*
# of meeting registrants
*
0 attendees $0 (I am only ordering CD or DVDs or paying for tour)
1 attendee $250
2 attendees $450
3 attendees $650
Names of other attendees
Optional FRIDAY Ship Channel Tour of the port of Houston:
(Departs hotel at 1:15pm)
0 for Tour
1 person - $25
2 people - $50
3 people - $75
Optional FRIDAY Mass Casualty Care Course w/ Dr. Hatfill:
(9am to 3pm) - includes lunch.
0 for Course
1 person - $100
2 people - $200
3 people - $300
Optional FRIDAY Mass Casualty Care Course w/ Dr. Hatfill: SOLD OUT
SOLD OUT
Optional MONDAY Ad Astra Rocket Factory Tour - 8am to Noon
0 for Tour
1 person - $50
2 people - $100
3 people - $150
Pre-order Meeting DVDs and CDs
Full Set of DVDs $150
Full Set of CDs $99
Payment Type
*
Mail in Check
Pay with Paypal (you can use your credit card)
Do Not Fill This Out