MEDA 2025 Winter Conference

Name: MEDA 2025 Winter Conference
Start: 2024-10-22T08:00:00-04:00
End: 2024-10-22T17:00:00-04:00

Tue, Oct 22 @ 8:00 am - 5:00 pm

"*" indicates required fields

Your Name*

First Last

Your email address*

Are you the attendee?

Yes

Attendee Name*

First Last

Attendee's Email*

Badge First Name*

Attendee's Title*

Organization*

Attendee's Address*

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

Phone*

Please specify any dietary restrictions.

Choose Your Ticket*

Winter Conference - Member ($100)

Non-Members/Others ($135)

Payment Type*

Pay by Credit Card

Pay by Check

Discount Code?

Total

Credit Card*

Note: If you are using a discount code that makes your total $0, you do not need to fill out this credit card field.

Card Details

Cardholder Name