Supported Life 2022 - February 3, 2022

Online Registration
Order #18341-1

1.

First Name    Last Name

leave name information blank and check here if this registration is for a yet-to-be-determined attendee
      (e.g. you do not yet know his or her name, but your organization is purchasing a block of registrations)

2.

Affiliation/Agency Name

3.
Address
4.
City    State    Zip Code
5.
Daytime Telephone (      

6.
Email Address
7.

I am a (select one registration type):    

Professional (or community member)
Person with a disability (paying FULL FEE)

Thanks to the generous support of the Supported Life 2022 co-sponsors we are able to offer a reduced registration fee for people with disabilities and family members who wish to attend the conference.

We do ask people with disabilities and their family members who work in the disabilities field to request that their agency pay the regular registration fee, to maximize our co-sponsors’ generosity.

Person with a disability (paying REDUCED FEE)
Family Member (paying FULL FEE)
Family Member (paying REDUCED FEE)
Other  

SPEAKERS: Do not register online. Use the speaker registration form that was mailed to you.

8.

I will be attending 

In-Person (limited, 1st come, 1st served)

Virtually (remotely via Zoom)

In-Person Safety Protocols

To do our best to safeguard the health of our In-Person attendees, the following steps will be taken.
  • Proof of vaccination is required before entry.
  • Masks are required to be worn at all times except during the meal break or in the act of eating or drinking.
  • Seating will be spaced and the room set in classroom style.
  • Attendees will maintain their same seat throughout the day
9.
 $
  • If you are purchasing more than one registration, this amount will be added to your total
  • Javascript must be enabled in your browser in order to see your total cost reflected here. Your total cost will be visible on the next screen (prior to checking out).
  • Agency Group Discount: Register 4 and get One Free
    Please email Dana at dfaletti@supportedlife.org to register your group.

    10.

    Accommodations request? Please email Dana at dfaletti@supportedlife.org by 1/13/2022.

  • Click only once, then wait for the order summary page
  • You will have an opportunity to add additional registrations to your order prior to checking out.
  •