Meeting Registration

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Speaker Registration is complimentary for those attending only the day they speak. If you would like to attend the full meeting, the regular registration fee applies.

Please email your abstract (title and presentation description) and a brief biography to be published on the website by December 20, 2019. Please email your PowerPoint by January 3, 2020 at the latest.

Speaker Registration

* Indicates required field

Name *

First

Last

Organization *

Email *

Phone Number *

Title *

Title of Your Presentation *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Program Materials & Bio

Submit your program description and bio to Veronica via email by December 20 to be included in the program. PowerPoints should be submitted by January 3. Send to 4statesic@gmail.com.

Audio/Visual Needs (check all that apply) *

Power Point (send to Veronica by Jan. 3 to be pre-loaded on our computer) Internet Connection Sound Hook-up (for any videos)

Everyone will have a microphone and a podium. Let us know what else you'll need.

Speaking *

Wednesday Thursday Friday

Regarding Your PowerPoint *

Yes, you may post it to the website as a PDF. No, you may not post it to the website. I am not using PowerPoint.

Days Attending *

Day I'm Speaking Full Meeting, invoice me $200

If you are only attending the day you speak, there is no charge. If you are attending more than one day, we ask that you pay registration fees.

Any special needs or concerns? *

Banquet Meal Choice (if attending Thursday evening banquet) *

Beef Chicken Vegetarian Gluten Free Not Attending the banquet

Please make your meal selection for the banquet. If you choose vegetarian or gluten free, that will be your option for lunch Thursday also. If you're not attending the banquet but need a gluten free or vegetarian lunch, please make a note in the special needs section.

Submit

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