Conference Registration Form

Your Name:*

First NameLast Name

Your Email Address:*

Company you represent: (Optional)

Are you a resident of the US?*

If you live in a country other than the USA, please give us your entire address here.

Your Address if you live in the United States:

Street Address

Street Address Line 2

CityState

Zip Code

Please check here if you will be requesting pending CE credits.

I will need ACVREP creditsI will need a Certificate of AttendanceI will not need CE credits

Does your company require a purchase order in order to pay for conferences? If so, please skip the Payment section below and go to the "Company requires a P.O. Section" and fill in that section completely.

Will you be attending In-Person or Virually?

In PersonVirtually

PAYMENT SECTION: (Choose One, Please)

AVRT Member Conference Registration

Includes the processing fee.

$225.00 Quantity

AVRT Conference Student/Retiree Registration

Conference registration for students only.

$210.00 Quantity

Non-AVRT Member Registration

Includes the processing fee.

$300.00 Quantity

Enter coupon

Total

$0.00

Company requires a P.O. Section

Company Name:

Contact Person:

First NameLast Name

Contact's Email Address:

example@example.com

Contact's Phone Number:

Please enter a valid phone number.Format: (000) 000-0000.

Number of people attending?

The first & last Names of the people attending the conference from this company. One name per line please. Please state if they are a AVRT member or not.

Special Needs - Comments - Questions

Please verify that you are human*

AVRT 2026 Conference