Positively U Activity Registration

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* 1. Full Name

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* 2. Email Address

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* 3. Date of Birth

Date / Time

Date

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* 4. Webinar Name

Managing HIV as a Chronic Disease- 11/23/2020 | 12:00 P

HIV & Inflammation- 12/3/2020 | 12:30 PM

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* 5. This webinar is a public forum and will be viewable by both participants of Positively U programs and general members of the community. (For your discretion, participant video and legal name is not required).

By selecting “yes,” I am expressing acknowledgement of the above statement and confirming that I am willfully registering for this event.

Yes

No