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22nd Annual
Julie Claire Gutterman Memorial Lecture
April 9, 2021 9:00 AM – 12:30 PM
Early Bird Registration Form
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:
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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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Registration Fee
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$40
-
Student attendee
$45
-
1 Attendee
$90
-
2 Attendees
$135
-
3 Attendees
$180
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4 Attendees
$225
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5 Attendees
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
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Attendee 4
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Attendee 5
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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