APA Division 45 Conference – 2021 Registration Form

Attendee Name *

Preferred Name

Gender Pronouns (Check all that apply)

He/Him/His

She/Her/Hers

They/Them/Theirs

OtherOther

Email *

Use same email as zoom account

Phone Number

Institutional or Organizational Affiliation

Current APA Division 45 Membership Status *

Member

Non-Member

Registration Type *

Undergraduate Student

Graduate Student

Post-Doctoral

Professional

Do you have any accommodation needs?

Conference registration fee for non-members include one-year (starting Jan. 1, 2022) membership to APA Division 45

Conference Registration Rates

Please fill out all required fields on this form. Refunds are available through June 7th, 2021. If you have any questions during this process or need to request a refund, please contact us at apadivision45conference@gmail.com

Early Bird Registration Ends on June 7th, 2021

Select Early Bird Conference Registration *

Professional Member Conference Early Bird ($125)

Professional Non-Member Conference Early Bird ($175)

Post Doc Member Early Bird ($75)

Post Doc Non-Member Early Bird ($100)

Graduate Student Member Early Bird ($45)

Graduate Student Non-Member Early Bird ($60)

Undergraduate Student Member Early Bird ($25)

Undergraduate Student Non-Member Early Bird ($35)

All fees includes Preconference Registration

Please Note: After choosing SUBMIT below, you will be taken to the secure payment authorization site and will not be able to return to this page. Also note that your reservation is not confirmed until payment is submitted.

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