Please use this button to print
& submit via fax to
(202) 632-0045
National Indian Gaming Commission
St. Paul Region
Attendee Information
Name (First & Last)
Business Street address
Business E-mail address
**All fields are required**
NOTE: Please use a separate form for each attendee
Business contact phone number
*include area code - numbers only please
Entity registrant represents
If you do not represent a Tribe/Tribal Casino/Tribal Gaming
Commission entity, please enter agency name above.
Please use this button to submit
via E-mail (Outlook or Internet
based e-mail)
For further information or questions, please contact:
Tribe Name
Regulatory Review Consultation
Hyatt Regency
Milwaukee, WI
June 13, 2011
Rita Homa
Executive Assistant
1441 L Street, N.W. Suite 9100
Washington, DC 20005
Phone: (202) 418-9807
Consultation Registration Form
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