AGACL – AGACL 2025 Conference Registration

Welcome to the AGACL 2025 Conference Registration

Your Name*

First Last

Your Affiliation/Office*

Title*

Your Email*

Phone*

Physical Address*

Street Address Address Line 2 City State ZIP Code

Is your mailing address different than your physical address?*

Yes

No

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Is this Registration for a AGACL Member(s) or Non-Member(s)?

Member

Non-Member

2025 Conference Registration - Member

Price:

Total number of Registrants (including yourself if applicable)*

Please fill out the names of each person attending below. If you are attending, please fill out your name as Registrant 1

Registrant 1*

First Last

Registrant 2*

First Last

Registrant 3*

First Last

Registrant 4*

First Last

Registrant 5*

First Last

Registrant 6*

First Last

Registrant 7*

First Last

Registrant 8*

First Last

Registrant 9*

First Last

Registrant 10*

First Last

2025 Conference Registration - Non-Member

Price:

Total number of (Non-Member) Registrants (including yourself if applicable)*

Please fill out the names of each person attending below. If you are attending, please fill out your name as Registrant 1

Registrant 1 (Non-Member)*

First Last

Registrant 2 (Non-Member)*

First Last

Registrant 3 (Non-Member)*

First Last

Registrant 4 (Non-Member)*

First Last

Registrant 5 (Non-Member)*

First Last

Registrant 6 (Non-Member)*

First Last

Registrant 7 (Non-Member)*

First Last

Registrant 8 (Non-Member)*

First Last

Registrant 9 (Non-Member)*

First Last

Registrant 10 (Non-Member)*

First Last

Total