Rural LISC Seminar

Attendee Registration Form

First Name

Last Name

Pronouns

Title

Organization

Eligible Rural LISC partner agencies have two in-person scholarships available that can be used to cover the cost of two in-person registrations. If you are a Rural LISC partner that qualifies for a scholarship, please select the scholarship option to waive your registration fee. Please contact ebradley@lisc.org if you have questions.

Will you be attending virtually or in-person?

We're at capacity for In-person registrations

Please detail any accessibility needs (including language and audio needs) you have for virtual engagement.

Are you a speaker at the seminar?

Phone Number

Mailing Address

Please detail any accessibility needs you have for in-person engagement.

Dietary Needs

I qualify for Rural LISC program scholarship

After you click the “Register Now” button, you will be redirected to the credit card payment page for the $450 in-person registration fee. If you need another option for payment, please still click “Register Now” then exit out of the credit card payment page and email ebradley@lisc.org.

Packages

Payment Section