Request for Official Letter to Attend

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To obtain an Official Letter of Invitation to attend the Midwest Clinic, please complete the following information. Please complete one form per attendee. We will email a PDF of the letter to you and another recipient per your request.

Email *

First Name *

Last Name *

Job Title *

Organization Name *

Address *

City *

State or Province *

Postal Code *

Country *

Phone Number *

Start date of attendance (please be sure to include extra days for travel if needed) *

YYYY

End date of attendance (please be sure to include extra days for travel if needed) *

YYYY

Would you like this letter sent to an additional recipient? *

Yes

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