Date/Time:
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Thank you for your interest in attending the Process Education Conference 2022. To reserve your place, please fill out the information below.
First Name
*
Last Name
*
Email Address
*
Title/Department
School/Affiliation
*
Phone number
*
Address 1
*
City
*
State
*
Postal Code
*
Photo & Video Release:
Videos, stills, and screen shots may be taken during the conference to be used for purposes such as Academy membership brochures, the Academy website, etc. If you object to your image being used for these purposes, please indicate NO, here.
*
Yes, you may use my image.
No
If someone recruited you to attend this conference, please tell us who!
Attendance Options
Note that you will have the opportunity to pay online (credit or debit card,
processed through PayPal) or by check once you have completed this form.
Select all that apply:
*
I plan to attend the conference online only.
Select one:
*
I am a student.
I am emeritus faculty.
I am employed at VSU or a partner school.
None of the above.
The options which appear below are based on the selections you just made.
You'll need to check the box beside the option to confirm that option.
Online Conference Participation
Registration for ONLINE Conference Participation ONLY
*
Online Conference Price $150.00
Registration for ONLINE Conference Participation ONLY (Student)
*
Online Conference Price $100.00
Registration for ONLINE Conference Participation ONLY (VSU or Partner School)
*
Online Conference Price $100.00
Registration for ONLINE Conference Participation ONLY (Emeritus Faculty)
*
Online Conference Price $100.00
+ Pre-Conference Student Success Workshop (Emeritus Faculty)
Workshop Price $75.00
Conference and/or Workshop Total:
$0.00
Calculate
Please note that you'll be able to see
an order overview on the next page
BEFORE submitting your information!
Comments/Questions
Did you attend last year's conference?
Yes
No