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Registration
Please select the number of attendees you are registering for the DVIP Conference and provide a name, email address, and phone number for each attendee. If you are registering just yourself you will select 1 attendee and complete the information requested and list yourself as the primary contact. A person registering a group of people and who is not attending the conference will only list themselves as the primary contact.
After completing the below registration form you will choose your method of payment (PayPal/Check).
ALL SALES ARE FINAL – NO REFUNDS.
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fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”address” field_title=”Address” field_type=”text” fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”city” field_title=”City” fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”state” field_title=”State” fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”zip” field_title=”Zip Code” fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”parent_caregiver” field_title=”Are you a provider serving parents/caregivers of youth at risk of entering the foster care system?” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.17.3″ _module_preset=”default” background_color=”RGBA(255,255,255,0)” background_enable_color=”on” global_colors_info=”{}”][/et_pb_contact_field][/et_pb_contact_form][et_pb_code _builder_version=”4.17.3″ _module_preset=”default” global_colors_info=”{}”][/et_pb_code][et_pb_text disabled_on=”on|on|on” _builder_version=”4.16″ custom_padding=”15px|15px|18px|15px||” disabled=”on” global_colors_info=”{}”]
Registration is now open.
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Thank you for your interest in DVIP Round Table.
Registration has reached capacity and is now closed.
If you would like to be placed on a waiting list, please contact Kate Meyer at kmeyer@ppep.org.
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