December 6 - 12, 2025 NAGC Delegation to Oman Application

Application Form

NAGC Oman, 2025
Please complete one application for each Professional Delegate or Guest
Application Status:*

Professional DelegateGuest- Cultural ProgramDelegation LeaderAssociation Staff
Professional Delegate Name (As you wish it to as you wish it to appear on your name badge)*

PrefixProfessional Delegate First NameProfessional Delegate Last Name
Guest Name (As you wish it to as you wish it to appear on your name badge)*

PrefixAccompanying Guest First NameAccompanying Guest Last Name
Participating with (Professional Delegate Name)

Professional Delegate First NameProfessional Delegate Last Name
Email*
example@example.com
Gender
Mailing Address*

Street Address (If PO Box, please also list street address)

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone Number*
Please enter a valid phone number.
Emergency Contact Full Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Professional Profile

To assist our delegation leader and overseas hosts in planning your professional program, and to best meet your expectations for this delegation, please complete the following professional profile. Please indicate the highlights of your career you wish to share.
Title
Employer
Years in Field
Please list brief highlights of your professional accomplishments we may share with overseas counterparts. This can include positions you have held, associations you that have been a part of, or awards you have received.
Please list up to three areas of interest/issues you would like to discuss during the professional exchange.
Passport Information- Information may be provided at a later date

Passport Required-All delegates must have a valid passport. You will be asked to provide a copy of your passport as part of the delegation preparation process. Your passport must be valid for at least six months beyond the completion of the delegation/extension/additional travel. It is recommended that passports have a minimum of 3 blank pages.
Are you able to provide your passport details at this time?*

YesNo, I will provide my passport information within the next 14 days.
Legal Name (as it appears on your passport)

Last NameMiddle NameFirst Name
Country of Birth
Citizenship
Date of Birth

MonthDayYear
Passport Number
Passport Expiration Date

MonthDayYear
Passport MUST be valid for 6 months following the delegation convene date
Passport Photo Page- copy upload

Please ensure all four corners of the passport are visible and the bar code, photo and text are legible.
Cancelof
Rooming Information

The Program fee is based on double occupancy, please select from the rooming options below.
Single Room Supplement: If you select a single room, you will be charged the additional single supplement. Please see program cost in Payment section.
Roommate Requested: Roommates are assigned based on application acceptance date. Roommate assignements are announced 30 days prior to departure.
Rooming Preference: *

Single RoomSpecific RoommateAssign Roommate- please specify below
I will be rooming with...

First NameLast Name
I/we prefer

Two bedsOne bed
Additional Information or Accommodations

Some delegates may require accommodations for special needs, including dietary and mobility. We will accommodate accordingly to the best of our abilities. Many of the countries with which the Citizen Ambassador Program conducts professional exchanges may not be equipped to meet your needs. We will make every effort to support requirements for travel. All rooms will be non-smoking, unless requested below. We will notify you if mobility issues would prevent you from participating in the program.
If there is any additional information you wish to add to your enrollment, please list in the Notes field below:
Authorization/Payment

Citizen Ambassador Program deposit. As the delegation will be limited, your deposit will secure your position on the delegation and your deposit will be applied towards the full program cost. $500 per delegate or guest is required.*

NAGC Delegation to OmanThe Program Fee is $4250 USD. The single room supplement is $950 USD. The program deposit, due at the time of application, is applied to the program fee.

$500.00

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Delegate signature*

Clear
Date*

MonthDayYear
Should be Empty:

Application Form

Please complete one application for each Professional Delegate or Guest

Professional Profile

Passport Information- Information may be provided at a later date

Rooming Information

Additional Information or Accommodations

Authorization/Payment