SOS 2023 Special Registration Form

SOS 2023 Registration

SAY IT LOUD!
ABOUT SOS

Since its founding in 2013, Saving Ourselves Symposium (SOS) has become a highly anticipated annual conference that educates and empowers the BlackLGBTQIA+ community in the South. The annual Conference, SOS 2023, will continue that legacy with a theme that speaks to the urgency of our times, the necessity of action and the importance of raising our voice in concert. The theme for this year’s convening will be: SAY IT LOUD! Sessions during SOS provide cutting-edge research, share promising health practices and strategies and celebrates the culture and creativity of the Black LGBTQIA+ community. This convening not only prioritizes the Black LGBTQIA+ community but also those who provide services. It is a unique and intentional space for the community to share with, learn from, and celebrate one another.

PRICING

Early Bird Registration (ends June 30): $250

Regular Conference Registration (July 1-July 31): $325

Late/Onsite Registration (August 1-6): $400
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Scholarship Recipient SOS 2023Presenter/Speaker at SOS 2023COMP Registration at SOS 2023Sponsorship Registration at SOS 2023Registration Paid by Agency/Someone Else

REGISTRATION INFORMATION
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FIRST NAME*
FIRST NAME
LAST NAME*
LAST NAME
Organization Affiliation (if any):
Title/Role:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone #
RACIAL IDENTITY*

Black or African AmericanAmerican Indian, Native, IndigenousAsianNative HawaiianPacific IslanderAlaska NativeWhiteI do not wish to provide this informationOther
ETHNICITY*

Hispanic or Latino/Latina/LatinxNot Hispanic or Latino/a/xNot SpecifiedI do not wish to provide this informationOther
GENDER IDENTITY*

MaleFemaleCisgender MaleCisgender FemaleTransgender WomanTransgender ManTransNon-BinaryIntersexGenderqueerGender-FluidGender Non-ConformingPangenderI do not wish to. provide this informationOther
SEXUAL ORIENTATION*

AsexualBisexualGayStraight (Heterosexual)LesbianPansexualPolysexualQueerQuestioning or UnsureSame-Gender-LovingAn orientation not listedI do not wish to. provide this informationOther
Required Pronouns:*
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E-mail:*

Will you be attending the Gala- August 5th (included in registration cost)*

YesNo
Will you be attending the Sunday Brunch- August 6th (included in registration cost)*

YesNo
Signature*

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