2023 Biennial Registration

2023 ARID Biennial Conference Registration Form

Connect 4
Pre-Conference Date: June 15, 2023 Conference Date: June 16-17, 2023 Location: Arkansas 4-H Center 1 Four H Way, Little Rock, AR 72223
Are you a sponsor using the conference registrations received with your sponsorship?*
- Yes, I am a sponsor
- No, I am a registrant (including Organizational Members)
Please select sponsorship tier:*
- 2 registrations (Diamond Sponsor)
- 1 Registrations (Platinum Sponsor)
Name*
First Last
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred mode of Communication*
- Voice
- Text
- Video Phone
Phone Number*
Interpreting services:*
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
Where would you like your CEUs reported?*
All participants will receive Certificates of Attendance to the email address provided. Certificates will be emailed within 45 days from the conclusion of the conference. If you have reporting needs other than RID or ARS, you are responsible for reporting CEUs. ARID reports CEUs to ARS and RID but ultimately the responsibility of CEU reporting falls on the credentialed interpreter. If you have any questions regarding the process of obtaining or reporting CEUs, please contact the ARID Professional Development Committee at: aridpdc@gmail.com.
- RID
- ARS (QAST)
RID Number*
2022-2023 ARID Membership Status (Select 1)*
Are you a member in good standing with ARID? If you are not in good standing with ARID please renew your membership when you are redirected to the Square website or fill out application form at https://www.arkansasrid.org/membership/application/ If you have any questions about payments please email treasurer@arkansasrid.org
- Yes, I am a Voting or Associate Member
- Yes, I am a Student Member
- Yes, I am an Organizational Member
- No, I am not an ARID Member
- Deaf Community Member
Conference Registration*
- Combo (June 15-17, 2023)
- Conference (June 16-17, 2023)
- Pre-Conference Only (June 15, 2023)
- Friday Only (June 16, 2023)
- Saturday Only (June 17, 2023)
Will you be staying on site? (Member - Combo)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Member - Conference only)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Member - Pre-Conference only)*
- No, I will be commuting
Name of Roommate (Member-Double Occupancy - Combo)*
Name of Roommate (Member-Double Occupancy - Conference Only)*
Will you be staying on site? (Student Member - Combo)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Student Member - Conference Only)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Student Member - Pre-Conference Only)*
- No, I will be commuting
Name of Roommate (Student Member-Double Occupancy - Combo)*
Name of Roommate (Student Member-Double Occupancy - Conference Only)*
Dietary needs:*
If you have any concerns about food allergies contact the Arkansas 4-H center directly.
- Vegetarian
- No dietary needs
Will both representatives be staying on site? (Organizational Member)*
- Yes, Two Single Occupancy
- Yes, One Double Occupancy
- No, both Representatives will be commuting
- No, One Representatives will be staying on site and one Representatives will be commuting
Which Representative will be staying on site? (Organizational Member)*
Organization Name*
Name (Organizational Representative 1)*
First Last
Email (Organizational Representative 1)*
Enter Email Confirm Email
Address (Organizational Representative 1)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred mode of Communication (Organizational Representative 1)*
- Voice
- Text
- Video Phone
Phone Number (Organizational Representative 1)*
Interpreting services (Organizational Representative 1)*
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
Where would you like your CEUs reported? (Organizational Representative 1)*
All participants will receive Certificates of Attendance to the email address provided. Certificates will be emailed within 45 days from the conclusion of the conference. If you have reporting needs other than RID or ARS, you are responsible for reporting CEUs. ARID reports CEUs to ARS and RID but ultimately the responsibility of CEU reporting falls on the credentialed interpreter. If you have any questions regarding the process of obtaining or reporting CEUs, please contact the ARID Professional Development Committee at: aridpdc@gmail.com.
- RID
- ARS (QAST)
RID Number (Organizational Representative 1)*
Dietary needs: (Organizational Representative 1)*
If you have any concerns about food allergies contact the Arkansas 4-H center directly.
- Vegetarian
- No dietary needs
Name (Organizational Representative 2)*
First Last
Email (Organizational Representative 2)*
Enter Email Confirm Email
Address (Organizational Representative 2)*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred mode of Communication (Organizational Representative 2)*
- Voice
- Text
- Video Phone
Phone Number (Organizational Representative 2)*
Interpreting services (Organizational Representative 2)*
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
Where would you like your CEUs reported? (Organizational Representative 2)*
All participants will receive Certificates of Attendance to the email address provided. Certificates will be emailed within 45 days from the conclusion of the conference. If you have reporting needs other than RID or ARS, you are responsible for reporting CEUs. ARID reports CEUs to ARS and RID but ultimately the responsibility of CEU reporting falls on the credentialed interpreter. If you have any questions regarding the process of obtaining or reporting CEUs, please contact the ARID Professional Development Committee at: aridpdc@gmail.com.
- RID
- ARS (QAST)
RID Number (Organizational Representative 2)*
Dietary needs: (Organizational Representative 2)*
If you have any concerns about food allergies contact the Arkansas 4-H center directly.
- Vegetarian
- No dietary needs
Will you be staying on site? (Non-Member - Combo)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Non-Member - Conference Only)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Non-Member - Pre-Conference Only)*
- No, I will be commuting
Name of Roommate (Non-Member-Double Occupancy - Combo)*
Name of Roommate (Non-Member-Double Occupancy - Conference Only)*
Will you be staying on site? (Deaf Community Member - Combo)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Deaf Community Member - Conference Only)*
- Yes, Single Occupancy
- Yes, Double Occupancy
- No, I will be commuting
Will you be staying on site? (Deaf Community Member - Pre-Conference Only)*
- No, I will be commuting
Will both representatives be staying on site? (Sponsor)*
- Yes, Two Single Occupancy
- Yes, One Double Occupancy
- No, both Representatives will be commuting
- No, One Representatives will be staying on site and one Representatives will be commuting
Name of Roommate (Sponsor - Double Occupancy - 1 Sponsor Lodging)*
If your representative will be staying in a single occupancy room put "None"
Will your representative be staying on site? (Sponsor)*
- Yes, One Single Occupancy
- Yes, One Double Occupancy
- No, the representative will be commuting
Name of Roommate (Sponsor)*
Name of Roommate (Deaf Community Member-Double Occupancy - Combo)*
Name of Roommate (Deaf Community Member-Double Occupancy - Conference Only)*
Would you like to pay in full now or use a payment plan?
- Pay in Full Now
- Payment Plan
Organizational Member Conference Registration*
Please contact president@arkansasrid.org to complete your registration.
- I understand an invoice will be generated in consultation with the ARID Biennial registration chair.
Sponsor Conference Registration*
Please contact president@arkansasrid.org to complete your registration.
- I understand an invoice will be generated in consultation with the ARID Biennial registration chair.
T-Shirts and Friday night banquet tickets
Are you looking for conference T-shirts? You will be able to complete your order for them on our Square page after you hit submit. If you want to order shirts later, you can visit the ARID website for more information on where the due date for orders will be posted. Are you planning on bringing a guest with you to the Friday night banquet? Tickets for additional guests can be purchased on the Square site after you hit submit, or at a later date from the ARID website no later than February 7, 2023

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2023 ARID Biennial Conference Registration Form

Connect 4

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2023 ARID Biennial Conference Registration Form

Connect 4

T-Shirts and Friday night banquet tickets

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Get in touch…

Our Google Group