SAHMS 2021 Registration

* Indicates required field

Name *

First

Last

Email *

Institution or Affiliation *

Mailing Address *

Phone Number *

Are you on the conference program? If so, in what capacity? *

Do we have permission to post your abstract and/or a recording of your lecture to the SAHMS website? *

Are you willing to serve as a technical moderator within the virtual platform? *

Are you willing to serve as a paper session moderator? *

Would you be willing to serve as a conference mentor? *

Are you seeking a conference mentor? *

Do you plan to attend the reception on Thursday evening? *

How did you hear about SAHMS? *

If your name differs from that on your method of payment, please note. Also, note here if you are paying for more than one registrant. Each individual registrant should submit a form, even if the payments are combined. *

Choose the category that applies to you. *

Select Add-ons *

Please note: SAHMS membership is not included in the registration fee and must be added on. Please help to keep our conference affordable and fund student attendance by paying your annual membership dues.

Once submitted, you will receive a message that includes a PayPal link and the mailing address for check payments to be sent. If you need additional confirmation of payment receipt, please send a request to sahmsconference@gmail.com.

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