GPSA Global Partners Forum 2018 - Registration Question Title * 1. First NameAs it appears in your passport OK Question Title * 2. Last NameAs it appears in your passport OK Question Title * 3. How would you prefer your name to appear on a conference badge? OK Question Title * 4. EmailPlease double-check that there are no typos in your email address OK Question Title * 5. Alternate Email OK Question Title * 6. Organization OK Question Title * 7. Title OK Question Title * 8. Phone (please include country code) OK Question Title * 9. Cell Phone (please include country code) OK Question Title * 10. Gender Male Female Other OK Question Title * 11. City of residence OK Question Title * 12. Country of residence OK Question Title * 13. Will you require a visa support letter to enter the USA? If you answer YES, the GPSA will supply a tailored letter of invitation to assist with the visa application. Participants are responsible for obtaining their own visas. Yes No OK Question Title * 14. Do you have any special requirements?Conference rooms are wheelchair accessible OK Question Title * 15. Emergency Contact Information (Name and Telephone) OK Question Title * 16. Is your organization a partner of the GPSA? Yes No Not yet, but am interested in joining the partnership OK Question Title * 17. Is your organization a grantee of GPSA? Yes No OK Question Title * 18. Have you attended GPSA Forum in the past? Yes No OK Question Title * 19. Are you applying for sponsorship?The GPSA provides limited sponsorship for participation in the Forum. Sponsored participants will be asked to play an active role in the Forum, such as speakers, rapporteurs, or moderators. Registrations that include a request for sponsorship need to be submitted by September 7. Priority will be given to participants from developing countries. Yes No OK NEXT