Please fill out the information below to register for this event.

Name (First and Last name of each attendee): *

Email (email for each attendee): *

Email of person completing this registration form: *

District *

Campus/Department (for each attendee) *

Registration Type *

DC Summit Only ($95/early bird $75)
DC Summit + Product Package ($135/early bird $115) - write your shipping address in Comments section for products
Digital Pass Only ($50/early bird $40 - no access to live event)
Digital Pass + Product Package ($90/early bird $80) - write your shipping address in Comments section for products
Group rate - if you are registering more than 10 - we will reach out to you with discounted pricing prior to payment

Planned Form of Payment

Purchase Order upload

Click or drag a file to this area to upload.

If your PO is not yet ready, just upload it once you have it or email it to us at: [email protected] You can also fax it to 866-729-4817.

Comments/Questions:

Phone

Online D & C Symposium Registration – March 6, 2021