2019 SART Planning Conference
Online Registration Application

YOU MUST COMPLETE ALL FIELDS OF THIS FORM.
LAST DAY TO SUBMIT YOUR REGISTRATION APPLICATION IS APRIL 19 BY 11:59 PM.

SECTION 1 – REGISTRATION INFORMATION
First Name: 
Last Name: 
Agency/Organization (no acronyms): 
Title: 
Work Address: 
Work City: 
Work State: 
Work ZIP Code: 
Work County: 
Work Phone: 
Email: 

SECTION 2 – OTHER REGISTRATION INFORMATION
Type of Affiliation (Select One)
County Government
State Government
Federal Government
Non-Governmental organization (NGO)
Independent
Local Animal Response Team
Other (Please specify if "Other")
 
Do you have a key role in animal and/or agricultural preparedness and/or response for your affiliation?
Yes No
 
What areas of animal/agricultural preparedness/response do you have a key role in for your affiliation?
Select all that apply.
ESF 17 Support at an Emergency Operations Center
Plan Writing
Animal Rescue
Animal Disease
Pet-friendly sheltering
Livestock and Large Animal Sheltering
Plants and Crops Agriculture
Livestock
Veterinary Support
Other (Please Specify if "Other")

SECTION 3 ATTENDANCE
I will attend all 3 days (May 29-31)
 
If you did not select all 3 days, select the days you plan to attend below:
I will attend Wednesday (May 29)
I will attend Thursday (May 30)
I will attend Friday (May 31)

SECTION 4 HOTEL SPONSORSHIP
SART is offering to sponsor a limited number of hotel rooms at the Sirata Beach Resort for our invited guests. This sponsorship will pay for the 2-night hotel room of $121 per night on May 29th and May 30th. This hotel sponsorship does NOT cover any other travel expenses.
 
Would you like to request to be considered for this hotel sponsorship opportunity?
Yes No
 
If you are not selected for the hotel sponsorship, is your agency/organization willing to pay for your travel, lodging and per diem expenses?
Yes No

SECTION 5 SURVEY INFORMATION
How did you hear about the 2019 SART Planning Conference?
Select all that apply.
E-mail invitation from SART conference organizer
SART Sentinel
SART Website
Coworker/colleague
Other (Please specify if "Other")
 
 
If you will require special accommodations for attending this conference, please contact the SART conference organizer, LeiAnna Tucker, at office phone (850) 410-0920 or via e-mail at LeiAnna.Tucker@freshfromflorida.com