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23rd Annual
Julie Claire Gutterman Memorial Lecture
April 8, 2022 9:00 AM – 12:30 PM
Early Bird Registration Form
Note
:
*
indicates required field.
Are you registering as an individual or an organization?
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Individual
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Contact Information
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(Student attendees must use their student email address)
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Promo Code
Enter your promo code if you are eligible for a discounted ticket.
Registration Fee
*
$50
-
Student attendee
$55
-
1 Attendee
$110
-
2 Attendees
$165
-
3 Attendees
$220
-
4 Attendees
$275
-
5 Attendees
Staff Registration Fee - Free
*
$0
-
Staff Free Ticket
If you need any special accommodations (e.g., accessibility), please indicate.
Additional Attendees
Attendee 2
First Name
Last Name
Email
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Attendee 3
First Name
Last Name
Email
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Attendee 4
First Name
Last Name
Email
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Attendee 5
First Name
Last Name
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For those who would like to remember Julie Gutterman, a donation may be made in her memory.
Donation amount
$
Add 3% to my total amount to help cover the payment processing fees