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2023 Statewide Conference
May 22-23, 2023. At the Ohio State University
REGISTRATION FORM
Name
*
First Name
Last Name
Organization
Position
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registration Options
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Monday-Tuesday, May 22-23: Breakfast-Lunch (two days)
$
75.00
Monday, May 22: Breakfast-Lunch (one day)
$
50.00
Tuesday, May 23: Breakfast-Lunch (one day)
$
50.00
Conference T-Shirt
$
25.00
T-Shirt Size
Small
Medium
Large
XLarge
2XLarge
Additional sizes by request
Dietary needs?
Vegetarian
Vegan
Allergy
Other
If allergy, what restrictions?
Need hotel? (Conference gets discount.)
Yes
No
Email
*
Phone
*
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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