Biennial Conference – Registration Form - Arkansas Registry of Interpreters for the Deaf

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Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing and Mailing Addresses are(Required)

The Same

Different

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you from Northwest Arkansas?(Required)

Yes

Would you like transportation assistance to Little Rock for the Biennial Conference? (Carpool, Van, etc.)(Required)

Yes

Undecided/Need more Information

If you would like more information about this option or would like to confirm your spot please contact vicepresident@arkansasrid.org

Phone numbers (Please select all that Apply)(Required)

Voice and Text Number

Text Only Number

Voice Only Number

Video Phone Number

Text and Voice Number(Required)

Text Only Number(Required)

Voice Only Number(Required)

Video Phone Number(Required)

Dietary Restrictions(Required)

No Restrictions

Vegetarian

Vegan

Gluten Free

Interpreting Services(Required)

Please indicate alternate types of communication access you require 2 weeks in advance of the conference.

No Services Needed

ASL Interpretation

Deaf-Blind: Tactile or Restricted Field

English Voice Interpretation

Other

Other Interpreting Services(Required)

Where would you like your CEUs to be reported? (Select all that Apply)(Required)

RID

QAST (ARS)

Certificate of Completion (for your records)

Enter your RID number(Required)

Would you like to Receive CEUs for the conference? (Discounted Rate when not receiving CEUs)

Yes, I want to receive RID/QAST CEUs

No, I just want to come and hangout with everyone and learn something new!

Would you like to pay in full now or use a payment plan?

Pay in Full Now

Payment Plan

What Membership level do you currently hold?

Voting

Associate

Student

Organizational

Do you identify as a part of the BIPOC community?

Yes

Early Bird - Member Rates (Voting, Associate, Organizational)(Required)

$250 - Full Conference - (Friday and Saturday)

$175 - Friday Only

$175 - Saturday Only

Payment Plan - Early Bird - Member Rates (Voting, Associate, Organizational)(Required)

Early Bird Payment Plans allow you to make 5 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $65 Initial Payment (4 additional monthly payments of $50)

Friday Only - $50 Initial Payment (4 additional monthly payments of $35)

Saturday Only - $50 Initial Payment (4 additional monthly payments of $35)

Regular Registration - Member Rates (Voting, Associate, Organizational)(Required)

$300 - Full Conference - (Friday and Saturday)

$200 - Friday Only

$200 - Saturday Only

Payment Plan - Regular Registration - Member Rates (Voting, Associate, Organizational)(Required)

Regular Registration Payment Plans allow you to make 3 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $115 Initial Payment (2 additional monthly payments of $100)

Friday Only - $81.67 Initial Payment (2 additional monthly payments of $66.67)

Saturday Only - $81.67 Initial Payment (2 additional monthly payments of $66.67)

Early Bird - Student Member Rates(Required)

$125 - Full Conference - (Friday and Saturday)

$100 - Friday Only

$100 - Saturday Only

Payment Plan - Early Bird - Student Member Rates(Required)

Early Bird Payment Plans allow you to make 5 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $40 Initial Payment (4 additional monthly payments of $25)

Friday Only - $35 Initial Payment (4 additional monthly payments of $20)

Saturday Only - $35 Initial Payment (4 additional monthly payments of $20)

Regular Registration - Student Member Rates(Required)

$125 - Full Conference - (Friday and Saturday)

$100 - Friday Only

$100 - Saturday Only

Payment Plan - Regular Registration - Student Member Rates(Required)

Regular Registration Payment Plans allow you to make 3 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $56.67 Initial Payment (2 additional monthly payments of $41.67)

Friday Only - $48.33 Initial Payment (2 additional monthly payments of $33.33)

Saturday Only - $48.33 Initial Payment (2 additional monthly payments of $33.33)

Early Bird - Non-CEU/Deaf Community Rates(Required)

$150 - Full Conference - (Friday and Saturday)

$125 - Friday Only

$125 - Saturday Only

Payment Plan - Early Bird - Non-CEU/Deaf Community Rates(Required)

Early Bird Payment Plans allow you to make 5 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $45 Initial Payment (4 additional monthly payments of $30)

Friday Only - $40 Initial Payment (4 additional monthly payments of $25)

Saturday Only - $40 Initial Payment (4 additional monthly payments of $25)

Regular Registration - Non-CEU/Deaf Community Rates(Required)

$175 - Full Conference - (Friday and Saturday)

$150 - Friday Only

$150 - Saturday Only

Payment Plan - Regular Registration - Non-CEU/Deaf Community Rates(Required)

Regular Registration Payment Plans allow you to make 3 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $73.33 Initial Payment (2 additional monthly payments of $58.33)

Friday Only - $65 Initial Payment (2 additional monthly payments of $50)

Saturday Only - $65 Initial Payment (2 additional monthly payments of $50)

Early Bird - BIPOC Rates(Required)

$200 - Full Conference - (Friday and Saturday)

$125 - Friday Only

$125 - Saturday Only

Payment Plan - Early Bird - BIPOC Rates(Required)

Early Bird Payment Plans allow you to make 5 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $55 Initial Payment (4 additional monthly payments of $40)

Friday Only - $40 Initial Payment (4 additional monthly payments of $25)

Saturday Only - $40 Initial Payment (4 additional monthly payments of $25)

Regular Registration - BIPOC Rates(Required)

$250 - Full Conference - (Friday and Saturday)

$150 - Friday Only

$150 - Saturday Only

Payment Plan - Regular Registration - BIPOC Rates(Required)

Regular Registration Payment Plans allow you to make 3 monthly payments. The first payment will include a $15 processing fee to cover the transaction fees.

Full Conference - (Friday and Saturday) - $98.33 Initial Payment (2 additional monthly payments of $83.33)

Friday Only - $65 Initial Payment (2 additional monthly payments of $50)

Saturday Only - $65 Initial Payment (2 additional monthly payments of $50)

Would you like to purchase additional Banquet Tickets **If your registration is on Friday you already have a banquet ticket for yourself**(Required)

Yes

Additional Banquet Tickets(Required)

Additional Banquet Tickets cost $45 each. **If you would like to purchase more than 3 additional banquet tickets you can do so by selecting the option on the Conference Landing page.

1 Additional Banquet Ticket

2 Additional Banquet Ticket

3 Additional Banquet Ticket

1st Additional Banquet Ticket - Registrant Info

Name	Dietary Restrictions	Interpreting Services	Actions

There are no Entries.

Maximum number of entries reached.

2nd Additional Banquet Ticket - Registrant Info

Name	Dietary Restrictions	Interpreting Services	Actions

There are no Entries.

Maximum number of entries reached.

3rd Additional Banquet Ticket - Registrant Info

Name	Dietary Restrictions	Interpreting Services	Actions

There are no Entries.

Maximum number of entries reached.

Would you like to purchase a conference T-Shirt?(Required)

T-Shirts cost $20 each.

Yes

What size T-Shirt would you like to purchase?(Required)

How many T-Shirts would you like in this size?(Required)

Please enter a number from 1 to 100.

Would you like to purchase additional t-shirt sizes?(Required)

If you want to purchase more than 3 additional sizes you can complete the Additional T-Shirt Order Form on the conference landing page.

Yes, one (1) additional

Yes, two (2) additional

Yes, three (3) additional

First Additional T-Shirt Size(Required)

Quantity of First Additional T-Shirt(Required)

Please enter a number from 1 to 100.

Second Additional T-Shirt Size(Required)

Quantity of Second Additional T-Shirt(Required)

Please enter a number from 1 to 100.

Third Additional T-Shirt Size(Required)

Quantity of Third Additional T-Shirt(Required)

Please enter a number from 1 to 100.

Total

Credit Card(Required)

Biennial Conference – Registration Form

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