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

AARC Member June 2
Non AARC Member June 2
Student June 2

Registration ends on June 1st at midnight for the June 2nd lecture.

AARC Member Group Purchase June 2

Price: $30.00

Non AARC Member Group Purchase June 2

Price: $40.00

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.

Total

$0.00

Name

This field is for validation purposes and should be left unchanged.

Registration for Pop Ups

Personal Information

Employment Information

Checks must be mailed to:

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