Local Community-Based, Non-Profit Practitioner: Conference Registration Fee Waiver Request
Only community-based, non-profit practitioners who: 1) have been accepted to present at the conference AND 2) work in one of the counties of the New York-Newark-Jersey City, NY-NJ-PA Metropolitan Statistical Area are waiver-eligible.
Local Metropolitan Area County/County Equivalent
*
Please Select
Bergen, New Jersey
Bronx, New York
Essex, New Jersey
Hudson, New Jersey
Hunterdon, New Jersey
Kings, New York
Middlesex, New Jersey
Monmouth, New Jersey
Morris, New Jersey
Nassau, New York
New York, New York
Ocean, New Jersey
Passaic, New Jersey
Pike, Pennsylvania
Putnam, New York
Queens, New York
Richmond, New York
Rockland, New York
Somerset, New Jersey
Suffolk, New York
Sussex, New Jersey
Union, New Jersey
Westchester, New York
Presenter Information
Name
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Place of Employment (Community-based, non-profit organization)
*
Professional Title
*
Organization Web Address
*
Conference Presentation
Submission ID
*
Title of Presentation
*
Submit
Should be Empty: