2023 Conference Registration

41st Annual MOLA Conference

June 2-5, 2023 | Berlin, Germany

Conference Registration

Registrations and payments must be received by Friday, April 21, 2023. Payments must be made in USD. All participants must register before attending the conference - please complete separate registration for each participant by filling out this form. You may pay online via PayPal or indicate your 'purchases' and send a check via mail separately.

Questions, please contact MOLA Administrator: Amy Tackitt, admin@mola-inc.org.

Name of Attendee*

Please enter name as you would like it to appear on your name tag

Pronouns

Email Address*

example@example.com

Name of Organization*

Telephone

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

YesNo

Yes, I would like to mentorYes, I would like to be paired with a mentorNo

YesNo

Online via PayPalI will mail a check or money order by Friday, April 21, 2023

June 2-5, 2023 | Berlin, Germany

Registration Options

Registration Options