QPC 2008 Registration Form

Return to the Queer Pin@y Conference 2008 homepage here.

To register for the conference, please complete the fields below.

First Name: Last Name:

School or Organization Affiliation:

Current Location (City, State): Age:

Email Address: Phone number:

I give permission for my contact information to be included in a listing that will be given to all conference participants after the conference is over:

If you are travelling with a group, do you prefer to be contacted through another person?

If yes, please list their full name here:

Please check if you require any food accommodations:

Vegan Vegetarian Allergies : if so please state here:

Do you need help finding accommodations? Yes, please contact me.

If you need to start over, please click on the RESET FORM button below:

If you are finished you may continue below.

Please double check that the information you have entered is correct. If you are ready to confirm your registration, you may click SUBMIT below. Once you click SUBMIT, the form will reset. This means your registration went through.

Thank you for registering for Illuminating the Queer Diaspora: the 7th Queer Pin@y Conference! Keep an eye out for future emails from the QPC 2008 Planning Committee. We will see you on November 1!

Complete my registration now: