2025 Americhem Leadership Meeting

2025 Americhem Leadership Meeting

Monday, February 24 - Thursday, February 27, 2025

Charlotte, North Carolina

Registration Deadline: Friday, January 24, 2025

Please list your name, title and department exactly as you would like them to appear on your name badge.

If you have questions regarding logistics, registration or hotels, please email sammy@eesagency.com. If you have questions regarding the program or Americhem, please email lmtryon@americhem.com
What would you like to do?*

NEW Event RegistrationCHANGE Registration and/or Hotel ReservationCANCEL Registration and/or Hotel Reservation
Registration Information
Name*

First NameLast Name
Preferred First Name for Name Badge*
Job Title*
Company*
Location*
Email*
example@example.com
Conference details will be sent to the above email. Would you like communications shared with an additional email address such as a family member, assistant or personal email?*

YesNo
Additional Email Address*
example@example.com
Cell Phone Number*

Country CodeArea CodePhone Number
Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shirt Size*

XSSmallMediumLargeXLXXLXXXLXXXXL
Allergies and/or Dietary Restrictions*

NoneGluten FreeHalalLactose IntolerantPeanut AllergyPescatarianShellfish AllergyTree Nut AllergyVeganVegetarianOther
List any medicines you are allergic to:*
List any medical conditions:*
This list will be only be shared with emergency personnel in the event of a medical emergency.
Emergency Contact
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Cell Phone Number*

Country CodeArea CodePhone Number
Hotel Reservation Information

Americhem will cover your room , tax, and resort fees over the event dates. You will be responsible for the cost of incidentals and will need to provide the hotel with identification and a credit card upon arrival.
Do you plan to stay at the Omni Charlotte?*

YesNo
Would you like to extend your stay? If so, please select your desired dates below.*

YesNo
Please Note: Any extension of your hotel stay will be at your own expense at a room rate of $255-295 per night plus taxes and fees unless otherwise approved by a manager or Lindsay.
Confirm Hotel Arrival*

MonthDayYear
Date - Hotel Check In is at 4:00 PM
Group Hotel Arrival*

MonthDayYear
Group Arrival Date
Confirm Hotel Departure*

MonthDayYear
Date
Group Hotel Departure*

MonthDayYear
Group Departure Date
Will you require assistance with hearing, vision, mobility or accessibility?*

YesNo
Please provide details regarding your needs.*
Additional Requests & Comments
Registration/Hotel Change Details*
Please note any changes to be made to your registration or hotel reservation.
Cancellation Details*
Please let us know why you are canceling your registration.
Should be Empty:

Registration Information

Emergency Contact

Hotel Reservation Information