American Society for Technion

Presidential Forum Registration

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REGISTRATION FORM

AMERICAN SOCIETY FOR TECHNION

PRESIDENTIAL FORUM: FRIDAY, OCTOBER 30 – SATURDAY, OCTOBER 31, 2015

AND

NATIONAL BOARD OF DIRECTORS MEETING: SUNDAY, NOVEMBER 1 – MONDAY NOVEMBER 2, 2015

THE RITZ CARLTON, WASHINGTON DC

As of 9/3/15

Please return this form by September 21st to the ATS in the enclosed envelope or via e-mail to or fax it to: (212) 753-2925, attn: Programs. If you have any questions, please contact the Programs Department at (212) 407-6300.

Yes, I/we look forward to participating in the ATS Presidential Forum,“The Power-of-Knowledge,”October 30 – 31, as a Benefactor (those who have made lifetime giving of $100,000 or more) or as a National Board Member or Chapter President. *

Yes, I/we will attend the ATS National Board of Directors Meeting, November 1-2, 2015.

 No, I/we will not be attending either program.

Name(s)

(PLEASE PRINT CLEARLY BOTH FIRST AND LAST NAMES OF EACH PARTICIPANT)

Address

City State Zip

Home Phone( )- Office ( )-

Email Address

HOTEL RESERVATIONS

We are pleased to offer two hotel options for you to choose from. All in-hotel events and meals will take place at the Ritz Carlton. Please reserve the following accommodations:

Presidential Forum Registration

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The Ritz Carlton Washington D.C.:

1150 22nd St NW, Washington D.C. 20037

Deluxe Room (King Bed) - $249.00/night

Deluxe Room (2 Double Beds) - $249.00/night

The Washington Marriott Georgetown

(2 minute walk to the Ritz-Carlton):

1221 22nd St NW, Washington D.C. 20037

Deluxe Room (King Bed) - $199.00/night

Deluxe Room (2 Double Beds) - $199.00/night

Presidential Forum Registration

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Please specify the night(s) you require hotel accommodations

Presidential Forum Registration

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Thursday, October 29

Friday, October 30

Saturday, October 31

Sunday, November 1

Monday, November 2

Other (please specify)

Presidential Forum and National Board of Directors Meeting Registration

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* You will be the guest of the American Technion Society for all Presidential Forum events, except transportation to and from the airport/hotel transfers, your hotel accommodations, non-program meals and incidentals. Please contact your tax advisor to determine the deductibility of any gift made to ATS in connection with your attendance or qualifying to attend this program.

Please indicate below the number of people who will participate in the following events.

PRESIDENTIAL FORUM:

FRIDAY, OCTOBER 30

1 2 Other _____7:45 – 8:15 am: Welcome Breakfast and Greetings

1 2 Other _____8:15 – 9:15 am: Behind-the-Scenes of the latest 2016 U.S. Election Headlines

1 2 Other _____10:15 – 11:45 am: Private briefing at White House Executive Office Building

For entry into the White house please provide the following:

Participant 1

Full Name (as appears on ID):______

Date of Birth: ______

Gender: ______

Social Security Number:______

Participant 2

Full Name (as appears on ID):______

Date of Birth: ______

Gender: ______

Social Security Number:______

1 2 Other _____12:15 – 2:15pm: Lunch and Program with Dennis Ross at Hay-Adams Hotel

1 2 Other _____3:00 – 5:00pm: Nano Bible presentation at the Smithsonian National Museum of American History

1 2 Other _____6:30 – 10:00 pm: Technion in the Global Community, Shabbat Reception and Dinner

SATURDAY, OCTOBER 31

1 2 Other _____7:45 – 9:30am:Inspirational Shabbat morning session with Seth Siegel

1 2 Other _____9:45 – 10:45 am: An Insider's Briefing on the Technion with President PeretzLavie

1 2 Other _____10:45 am – 12:15 pm:Curing Cancer Takes Center Stage at the Technion

1 2 Other _____12:30 – 1:30 pm:Lunch

1 2 Other _____1:45 – 3:15 pm:The Technion Touch: Inventions that Change Lives for the Better

1 2 Other _____7:00 pm:ATS 75th Anniversary Celebration at the National Portrait Gallery

NATIONAL BOARD OF DIRECTORS MEETING

SUNDAY, NOVEMBER 1

1 2 Other _____8:00 – 10:00 am: Personnel Committee Breakfast Meeting (Closed Meeting for Committee Members Only: Observers not permitted)

1 2 Other _____8:00 – 9:30 am:Open Breakfast

1 2 Other _____8:00 – 9:00 am:Planned Giving Committee Breakfast Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____9:15 – 10:15am:Campaign Resources and Public Affairs Committee Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____10:30 am – 12:00 pm:Budget Committee Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____12:15 - 1:30 pm:National Programs and Missions Committee Lunch Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____12:00 – 1:30 pm:Open Lunch

1 2 Other _____1:45 – 3:15 pm: Leadership Development Committee Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____3:30 – 4:30 pm:New Board Orientation Meeting(New Board Members Only)

1 2 Other _____3:30 – 5:30 pm: Investment Committee Lunch Meeting (Closed Meeting for Committee Members Only: Observers not permitted)

1 2 Other _____6:30 pm:Reception and Dinner at Ritz Carlton. Cost: $100 per person.

MONDAY, NOVEMBER 2

1 2 Other _____8:00 – 10:00 am: Finance/Transactions Committee Breakfast Meeting (Closed Meeting for Committee Members Only: Observers not permitted)

1 2 Other _____8:00 – 10:00 am: Open Breakfast

1 2 Other _____10:15 – 11:15 am: Planning Committee Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____11:30 am – 1:30 pm: National Board of Directors Meeting (Open Meeting for Committee Members and observers)

1 2 Other _____1:30 pm:Lunch

If you have any questions, please contact the Programs Department (212) 407-6300.