1. Registration

 
20% of survey complete.

Thank you for your interest in the 13th Annual Community Partners Conference: "Planning for Our Future, Reaching Our Goals."

To register for the 13th Annual Community Partners Conference, please complete the following:

Question Title

* Contact Information
Note: * Denotes a required field. If a field is not applicable to you, please input: N/A.

Question Title

* Please list any dietary restrictions.

Question Title

* What is your ethnicity? (Optional)

Question Title

* Is this your first time attending the Community Partners Conference?

Question Title

* The fee to attend this conference is $75.00. Please check off your preferred payment method. To ensure registration, checks must be received by August 22nd.

Question Title

* A limited number of partial travel stipends ($400 maximum) are available for out-of-town participants. Are you interested in applying for a travel stipend?

T