Day(s):Hour(s):Minute(s):Second(s) Conference Registration InformationName(Required) First Last Title(Required)CredentialsEmail(Required) Organization(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneLicense or Registration Number (Pharmacists/Technicians Only)Attendance Type(Required) General Attendee ($150) Virtual Attendee ($100) Student ($75) SDDOH Employee In-Person SDDOH Employee Virtual Exhibitor*Please note, while virtual attendance is available, spots are limited and preference will be given to attendees that have farther to travel. Please plan on attending in-person if you are able.Mailing ListUpon registering, you will automatically be enrolled to receive emails for all training opportunities. Please indicate below if you would NOT like to be notified of future trainings.Photo ReleaseI hereby give my permission to Immunize South Dakota to use any photos taken during the ISD Conference and any ISD hosted social functions. The photos will be used for the ISD Newsletter and social media. I agree I do NOT agreeCredit CardCardholder NameCard DetailsTotal Cancellation Policy(Required)No Registration will be final until payment is received. All cancellations must be confirmed in writing and must be received by ISD administration by September 15. Cancellations received on or before the September 15 deadline will be assessed a $25 processing fee. Cancellations received after September 15 are not refundable. No Shows are not refundable - no exceptions. Please allow two to three weeks following the conclusion of the conference for refund processing. No refunds will be processed prior to the conference. I have read and understand the cancellation policy
