Accommodations Form - September 27

September 27, 2024 Session
Accommodations Form

Judicial Education Program

Educating the Judiciary about the Social Determinants of Health (SDOH)

Friday, September 27, 2024

Venue: Northeastern University - Charlotte, North Carolina

Registered Salus Populi Attendee Name

Do you plan to attend the Salus Populi judicial education program at Northeastern University - Charlotte, North Carolina on September 27, 2024 from 8am to 5pm?

I plan to attend

I can no longer attend

Salus Populi will pay for attendees coming from out of town for up to two nights (September 26th and 27th). Please confim if you will need hotel accomodations

I will need accommodations for the evening of September 26 only

I will need accommodations for the evening of September 27 only

I will need accommodations for both evenings (September 26 and 27)

I will not need hotel accommodations

Salus Populi will host a welcome sit-down dinner on Thursday, September 26th from 6:00pm to 9:00pm at Mimosa Grill. Please confirm if you plan to attend.

I plan to attend

I do not plan to attend

Salus Populi will pay for a flight or train travel for attendees coming in from out of town. Please confirm below:

I will need a roundtrip flight.

I will need a roundtrip train ticket.

I will not need a flight or train ticket.

Legal Name on ID you will show at the airport/on train ticket

Mobile phone number

Email address you prefer flight/train confirmation email be sent to

Date of birth

What is your gender identity?

Date of flight to Charlotte

Preferred airport/train station for trip to Charlotte

Preferred airline for trip to Charlotte

Preferred Flight Number

Preferred departure time from home city

Preferred arrival time to Charlotte

Date of return flight to home city

Preferred airport/train station for return trip

Preferred airline for trip to home city

Preferred Flight Number

Preferred departure time from Charlotte

Preferred arrival time to home city

Please feel free to use this space, or email Project Coordinator Anna Kane at an.kane@northeastern.edu, with any notes or questions.

Thanks for submitting! A member of the Salus Populi team will be in touch with you shortly.

September 27, 2024 Session Accommodations Form

September 27, 2024 Session
Accommodations Form