Registration for Stigma Assessment Cycle gathering October 13, 2022

 

We look forward to welcoming you on October 13, 2022 in what is colonially referred to as Vancouver.  Please complete the form so we can best support your participation. Once all the required sections are complete, hit submit at the bottom.

Registration Information

Information collected on this form is confidential and will be used solely by PAN. All questions marked with a * require a response.
By completing and submitting the information requested in this online application form I am acknowledging that I have read, understood and accept the COVID-19 protocol, travel and accommodation guidelines, and the expense reimbursement guidelines as they apply to me.(Required)
Name(Required)
I will attend the meeting:(Required)
We're asking this so we can budget and arrange for meals (and accommodation as required for those from out of town). If your attendance status changes between registration and the event, please advise Janet immediately: [email protected]
I have had at least two COVID-19 vaccines and can provide proof on request.(Required)
Please review the Face-to-Face Meeting Protocol.
I have reviewed and agree to the Face to Face Meeting Protocol.(Required)
I have reviewed Travel Reimbursement information on event page.(Required)
People requesting travel reimbursement will be contacted for further information.
I understand that reimbursement for travel-related expenditures will not be made unless receipts for all items requested are provided to PAN and submitted with my request.(Required)

Hotel Reservation Information

PAN has a block of rooms set aside and will book on behalf of attendees.
I understand that if I require a hotel room in addition to October 12, I will contact Janet Madsen as soon as I have submitted this registration.
Janet Madsen: [email protected]

Media Release

Sometimes we take photos of people or projects that we use on our website, in our e-newsletter, or for other educational use. Please indcate if you would NOT like your photo taken.
Do you wish to have a special nametag to indicate that you DO NOT want your photo taken or used?(Required)

Emergency Contact

Do you give us permission to get in touch with your emergency contact if needed?(Required)
We require an ermgency contact for anyone who is attending in person.
Name