Registration Waiver Request for the June 21-23, 2021 Education for Equity & Democracy Symposium

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Complete this form if you are requesting a partial or full waiver of the registration fee ($120 or $240 w/PDPs and CEUs). We want this symposium to be accessible and do not want the registration fee to block your participation. Please respond to the questions below and we will respond with an email on or before June 10, 2021.

Name and Email Contact *

Role and/or Affiliation *

Why do you want to attend this symposium? (Just a few sentences is sufficient.) *

How much of a registration waiver are you requesting? *

50% waiver (waive $60 for general registration)

50% waiver with CEUs/PDPs (waive $120)

100% waiver (waive the full $120)

100% waiver with CEUs/PDPs (waive $240)

Other:

Are there any other comments you would like to make to the Symposium organizers? (optional)

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