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BTC 19 REGISTRATION
REGISTER FOR THE BREAK THE CYCLE 19 IN PERSON & VIRTUAL CONFERENCE
(you will receive a zoom link 2 days before the conference)
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* Indicates required question
Email
*
Your email
First Name,
*
Your answer
Last Name
*
Your answer
I am a
*
Student
Faculty
Staff
Community Member
Other:
Affiliation
*
Your answer
Which Day/Days will you attend?
This year the BTC conference will be held in person and online, on
APRIL 15+16 2024.
Please indicate which days and how you plan to attend:
DAY 1 Monday April 15 (Student Presentations)
*
Please check how you will be attending Day 1
DAY 1: IN PERSON
DAY 1 : ONLINE
I will not be attending DAY 1
DAY 2 Tuesday April 16 (Symposium on Mental Health Disparities)
*
Please check how you will be attending Day 2
DAY 2: IN PERSON
DAY 2 : ONLINE
I will not be attending DAY 2
Anything else you would like us to know
Your answer
A copy of your responses will be emailed to the address you provided.
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