ADPCA 2025 Conference Registration Form

ADPCA 2025 Conference Registration Form

Please complete this form to register for the 2025 ADPCA conference taking place at Loyola University of Chicago, Lakeshore Campus, in Chicago, IL USA on June 25th-29th, 2025. Please email us with any questions about this form: conference2025@adpca.org
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Full conference - traveling within continental USA: $275.00Full conference - traveling from residence outside the continental US with work sponsorship: $275.00Full conference - self-paying travelers from residence outside the continental US: $0.00
If you cannot pay the full conference fee, please enter the amount you are able to pay in the Total Due box below and pay that amount.
Donation towards conference registration fee scholarships?
Please enter dollar amount of donation.
YesNo
Accommodation type is charged per person per night. Please choose which days you would like to stay. The conference begins on Wednesday at 3:30pm and ends on Sunday at 12pm. The accommodation check in begins at 3:30pm and check out ends at 10:30am.
Double occupancy - community bathroom: $70.44Double occupancy - private bathroom: $88.05Single occupancy - community bathroom: $93.95Single occupancy - private bathroom: $117.40
Tuesday, June 24thWednesday, June 25thThursday, June 26thFriday, June 27thSaturday, June 28thSunday, June 29thMonday, June 30th
I would like to request the following person as a roommate:

First NameLast Name
If you do not choose a roommate, someone will be chosen to fill the space. If you do request a specific sharer, they will also need to complete a booking form.
Total Due
Check: payable to Bertrand Rice; send to 6240 N. Magnolia Ave, Apt. 1, Chicago, IL 60660Zelle: payable to moonrice@earthlink.netCredit card

Should be Empty:

Payment Details
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