Caregiving Research Conference 2022

Act Now! Early Bird Prices END on July 15, 2022

	Price through July 15, 2022	Price AFTER July 15, 2022
General Registration	$295.00	$400.00
Post-Doctoral & Clinical Trainees	$100.00	$175.00
Students	$25.00	$50.00

Name. *

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

Please enter a valid phone number.

Email *

example@example.com

Credentials

Job Title *

Organizational Affiliation *

Discipline *

Primary Role *

What is your age group?

What is your current gender identify?

Are you Hispanic/Latino?

Yes No

What is your race/ethnicity? Check all that apply.

Native American or Alaska Native Asian Black or African American Native Hawaiian/Other Pacific Islander White Unknown More than one race I prefer not to disclose Other

What is your personal experience with disability & caregiving? Check all that apply. *

I am currently a caregiver. I was previously a caregiver. I am a person who has a caregiver. None Prefer not to answer Other

Use the following guide to answer the next question.

Please list your your areas of research interest. *

	List your top three (3) areas of interest from the document above.
Interest Area 1
Interest Area 2
Interest Area 3

Accomodations

The DoubleTree Hotel event spaces are ADA compliant, however, we realize you may need additional disability-related accommodations. Please describe any accommodations you may need, if applicable:

Do you have any dietary restrictions? *

No Yes

What is your dietary restriction? *

Vegetarian Vegan Gluten-Free Kosher Other

Photography

From time to time, the National RRT Center on Family Support (NCFS) and its contractors record, photograph and/or stream the various aspects and activities of the Conference on Caregiving Research for educational, archival, and promotional purposes. By attending the Conference on Caregiving Research, attendees give NCFS and its contractors permission to use attendee's voice and image in any such educational, archival, or promotional recording, photograph, or streaming activity.

Please check the following: *

I have read the above photography statement and agree. I have read the above photography statement and I do NOT wish to be photographed.

Select the type of continuing education certificate that you would like. *

Nursing Certificate Social Work Certificate Participation Certificate None

Have you been given a special identifier for this educational activity? *

Yes No

Please enter your ID CODE: *

Registration Type - Please choose the appropriate registration type. You will receive confirmation from our trusted partner, Authorize.net. when your payment has been accepted. Please remember to click submit to complete your registration. *

General Registration

$ 295.00

Post-Doctoral and Clinical Trainees

$ 100.00

Students

$ 25.00

Total

$ 0.00

Credit Card
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Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Refunds and Cancellation Policies

No refunds will be granted for the Conference on Caregiving Research AFTER September 15, 2022 11:59 pm EST. All requests to cancel a registration must be made in writing (email notification is acceptable). All requests must be submitted to conted@pitt.edu.

The University of Pittsburgh School of Nursing reserves the right to cancel a learning activity. In the event of a cancellation by the University of Pittsburgh School of Nursing, registrants will receive a full refund for their registration fees.

Conference and Hotel Information

DoubleTree by Hilton Hotel & Suite Pittsburgh Downtown

One Bigelow Square, Pittsburgh, PA 15219

Nursing Continuing Professional Development Accreditation Statement

The National Rehabilitation Research and Training Center on Family Support at the University of Pittsburgh and the University of Pittsburgh School of Nursing are collaborating to provide 10.75 nursing continuing professional development (NCPD) contact hours for the educational activity entitled Building Bridges: Advancing Family Caregiving Research Across the Lifespan. The University of Pittsburgh School of Nursing is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

DoubleTree by Hilton Hotel & Suites - Pittsburgh Downtown