Please complete the following registration form in order to attend this year’s Annual Meeting.
Annual Meeting Registration 2023 Basic Information First Name * Last Name * Email Address * Phone Number Affiliation Address * Address Street address 1 Street address 1 Street address 2 (optional) Street address 2 (optional) City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Membership Status * I'm a member and my registration is current I would like to become a member or renew my membership - $15 I do not want to become a member at this time I am a Student - FREE membership is offered. If you would like to become a member at this time, please fill out the membership questions below before continuing. Application Type * New Member Renewal Area(s) of Expertise: * Separate interests with commas (,) or enter each interest on a new line. Interested in Being a Speaker? * Yes No Category of Employer * Academic Government Professional (Business/Industry/Independent) I'm a Student Would you like to participate on chapter committees? * Yes No Meeting Registration Category * Member - $175 Non-Member - $225 Student - $25 Student Presenter - $0 Meeting Sponsor - $500 ($500 level - one attendee) Break Sponsor - $250.00 ($250 level - one attendee) Not attending this function - $0 Short Course Registration Category * Member or Government Entity - $50 Non-Member - $85 Student - $20 Not attending this function - $0 For Short Course Registrants: Will you need LSP Credit attendance certification (4 technical credits)? Yes - No Are you registering additional people? * No Yes, 1 person Yes, 2 people If yes, you will need to list the name(s) and the total amount of registration costs. Additional registrants will need to fill out a separate registration form. Additional Registrant Information First and Last Name of Additional Registrant * Registration Fee Cost Enter the total amount from this person's registration form. Second Additional Registrant Information First and Last Name of Second Additional Registrant * Registration Fee Cost Enter the total amount from this person's registration form. Total Payment Options * Check Paypal/Credit/Debit Card Another person will be paying on my behalf IMPORTANT: If paying by check, please bring the check to the meeting and pay when you check-in for the conference. Information for Person of Contact Regarding Payment Used to connect payments to registrants. First and Last Name * Email Address * Captcha Δ
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