Thank you for your interest in attending the HIV R4P Advocates' Pre-Conference Workshop. There is no fee to attend the workshop, but attendees are required to register in advance, and sign-in on site. Please fill out the following registration form.

Capacity is limited. You will receive confirmation of your attendance closer to the conference.

The workshop will take place at the Sheraton Grand Chicago on Monday, October 17 from 8:30am to 3pm CT. 


Name

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* 1. Name

Gender (for reporting participant demographics only)

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* 2. Gender (for reporting participant demographics only)

Organization/Affiliation

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* 3. Organization/Affiliation

City, Country you live and work in

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* 4. City, Country you live and work in

Telephone number (please include country code)

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* 5. Telephone number (please include country code)

Email

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* 6. Email

Confirm email

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* 7. Confirm email

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