Supported Life 2024 - October 17 - 18, 2024

Online Registration
Order #21647-1

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 -- includes self-advocates and families funded through an agency)

The generous support of Supported Life 2024 co-sponsors  allows us to offer reduced registration fees to people w/disabilities & family members attending the conference not funded through a State Agency, Regional Center or Service Provider Agency. 

We want to ensure all individuals and family members who are solely reliant on their personal funds can receive the subsidy to help them attend.
Person with a disability (paying REDUCED FEE -- not funded through a State Agency, Regional Center or Service Provider Agency)
Family Member (paying FULL FEE -- includes self-advocates and families funded through an agency)
Family Member (paying REDUCED FEE -- not funded through a State Agency, Regional Center or Service Provider Agency)
Other  

SPEAKERS: Do not register online. Use the speaker registration form that was mailed to you.
8.

I will be attending (check all that apply):

Thursday conference day
Friday conference 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).


    • Refund Policy  
  •  Cancellations must be in writing & received by 9/20/24
  • Cancellations after 9/20/24 (Including “No Shows”) Cannot be refunded
  • With advance notice, substitutions are welcome.
    • 10.

    Accommodations requested:

    Medically-recommended diet
    Vegetarian lunch preferred
    Sign Language interpreting services
    Accommodations for conference materials
          Please specify request (note: all requests for accommodations must be received in
          the Supported Life Institute office by September 26, 2024    ):
            

    11.

    Please indicate your preliminary choices of which concurrent sessions you are interested in attending (one choice per session time). You are still free to attend any session you wish at the conference.

    Thursday, October 17th
    Friday, October 18th
    10:20 - 11:25
    2:10 - 3:15
    3:25 - 4:30
    10:10 - 11:20
    1:45 - 2:55
    3:05 - 4:15
    1A
    2A
    3A
    4A
    5A
    6A
    1B
    2B
    3B
    4B
    5B
    6B
    1C
    2C
    3C
    4C
    5C
    6C
    1D
    2D
    3D
    4D
    5D
    6D
    1E
    2E
    3E
    4E
    5E
    6E
    1F
    2F
    3F
    4F
    5F
    		  

  • 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.

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