67th Annual MODSEA Conference Registration

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Please use this form to complete your registration for the Wednesday, February 22, 2023 conference being held virtually. Kindly register by February 15th.

Thank you for taking the time to complete this form, we look forward to seeing you at this fantastic event.

Email *

Your Name *

Cell Phone # (only used to communicate any issues pertaining to conference logistics) *

Organization Name or School District *

Your Role in Organization or School District *

Attending In-Person or Virtually? *

In-Person @ MODOT

Virtual on Zoom

Are you interested in becoming a MODSEA officer?

Yes

Maybe

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A copy of your responses will be emailed to the address you provided.

Submit

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