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ALARA 2023 Conference Registration
Hi there, please fill out and submit this form to complete your registration and submit your payment for the conference.
11
Questions
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1
Name
*
This field is required.
First Name
Last Name
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2
Please write your name as you'd like for it to be shown on your badge/program.
(If same as above you can skip this step)
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3
Pronouns
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4
Email
*
This field is required.
example@example.com
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5
Phone Number
Country Code
Area Code
Phone Number
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6
Academic Affiliation or Other Affiliation
*
This field is required.
If you are not affiliated with a University or organization, you may write ALARA or Independent Scholar.
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7
Please choose the one that describes you best
*
This field is required.
Student
Faculty
Administrator
Staff
Retiree
Independent Scholar
Other
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8
Short Biography
*
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Below please include a short biography (No more than 200 words).
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9
Please confirm whether you will be attending the conference in-person or virtually.
*
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In-Person
Virtually
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10
Invoice ID
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11
Conference Registration Fee + Membership dues
In the next slide please choose between options 1-4 and select the appropriate payment tier for your participation. Click NEXT to continue.
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12
My Products
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My Bag
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My Bag
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$20
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Great Product Name
$20
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ORDER SUMMARY
Total cost
USD
In-Person: Full-Time Faculty
This fee includes conference registration for in-person attendance and a two year membership in ALARA.
$
275.00
+
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Virtual: Full-Time Faculty
This fee includes conference registration for virtual attendance and a two year membership in ALARA.
$
245.00
+
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In-Person: Students and Retirees
This fee includes conference registration for in-person attendance and a two year membership in ALARA.
$
225.00
+
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Virtual: Students and Retirees
This fee includes conference registration for virtual attendance and a two year membership in ALARA.
$
200.00
+
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