Pop Up Registration

Personal Information

Name*

First Last

AARC Number

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone

Email*

Enter Email Confirm Email

Employment Information

Facility or School*

If you are looking to register a group, you must choose the job title of manager

Job Function*

Special Note About Registration

Registration automatically enters you into a drawing for the listed donated prize

All proceeds will go to the CTSRC Scholarship Funds

Registration limited to the first 100 people

If you are looking to register a group, you must choose the job title of manager

Registration Options

Registration ends on May 20th at midnight for the May 21st lecture and June 1st at midnight for the June 2nd lecture.

AARC Member Group Purchase For May 21

Price: $30.00 Quantity:

Non AARC Member Group Purchase May 21

Price: $40.00 Quantity:

Non AARC Member Group Purchase June 2

Price: $40.00 Quantity:

AARC Member Group Purchase for Both Lectures

Price: $55.00 Quantity:

Non AARC Member Group Purchase for Both Lectures

Price: $75.00 Quantity:

Total

$0.00

Refund Policy*

It is policy of the CTSRC that all cancellations must be submitted in writing, 14 calendar days before the scheduled event to be eligible for a registration fee refund. Refund requests must be made in writing to Maureen Parmelee at maureen.parmelee@gmail.com. A $25 administrative fee will be deducted from the refund.

I have read the refund policy.

Payment Choice

When you click REGISTER NOW, you will be directed to the PayPal site to complete your transaction. Payment can be made using a credit card OR by using your Pay Pal account.

Checks must be mailed to:

CTSRC

c/o Maureen Parmelee

90 Creamery Rd

Durham, CT 06422

Checks must be received 2 weeks before the event to be valid.