2025 Registration Form

Name of Person Completing Registration Form(s)*

First Last

Institution of Person Completing Registration Form(s)*

(e.g. State University, Bigtown College-Secondcampus, etc.)

Preferred Email of Person Completing Registration(s)*

in case there is a question

Campus Phone of Person Completing Registration(s)*

in case there is a question

Is there a gen ed committee/program/office/department/school on campus?*

Yes
No

What is the official name of the above gen ed entity?

Is there a person who overseas the gen ed entity on your campus?*

Yes
No

This could be an administrator, committee chair, director, etc.

Please provide the name, position title, and email address of the person(s) who oversee the gen ed entity on your campus (if applicable).

If available, campus address for above gen ed entity.

(e.g. Main Hall Rm 100, MC1000, etc.)

If available, web address to the above gen ed entity.

(e.g. www.stateuni.edu/gened)

I understand I may be contacted with questions regarding the registration(s) submitted.*

I understand

Do you have more than 5 people to register?*

Yes, please contact me about registering a group of 6 or more. [hit submit to end registration; we will contact you within 48 hours]
No, I have 5 or fewer to register. I will complete the form below.

I am registering for:*

Myself Only
Myself and Others
On behalf of one person
On behalf of a group

Attendee #1 Name*

First Last

Attendee #1 Preferred Email*

Please provide attendee's email address

Registration for Attendee #1*

Workshop Registration for Attendee #1

select option for workshops offered on Thursday, October 2

Do you have a second attendee to register?

Yes
No

Attendee #2 Name

First Last

Attendee #2 Preferred Email

Please provide attendee's email address

Registration for Attendee #2

Workshop Registration for Attendee #2

select option for workshops offered on Thursday, October 2

Do you have a third attendee to register?

Yes
No

Attendee #3 Name

First Last

Attendee #3 Preferred Email

Please provide attendee's email address

Registration for Attendee #3

Workshop Registration for Attendee #3

select option for workshops offered on Thursday, October 2

Do you have a fourth attendee to register?

Yes
No

Attendee #4 Name

First Last

Attendee #4 Preferred Email

Please provide attendee's email address

Registration for Attendee #4

Workshop Registration for Attendee #4

select option for workshops offered on Thursday, October 2

Do you have a fifth attendee to register?

Yes
No

Attendee #5 Name

First Last

Attendee #5 Preferred Email

Please provide attendee's email address

Registration for Attendee #5

Workshop Registration for Attendee #5

select option for workshops offered on Thursday, October 2

Institutional Member Discount

Available for institutions that paid 2025-26 Institutional membership. Our office should have sent you a code to use.

Would you like to pay now with a credit card OR have AGLS send you an invoice?*

Pay now via credit card / Paypal
Invoice me

Please enter name and email of person to receive invoice via email

Please send an invoice for above registrations to the following person – provide name and email above. (e.g. Jane Smith, jsmith@unitown.edu) NOTE: Registrations are not active until payment is received.

If paying with a credit card now*

PayPal is the AGLS credit card processing portal. You DO NOT need to have a PayPal account. You can pay with a credit card. Simply select the option to pay as a guest/with a credit/debit card.

I Understand

Total

$0.00

Name

This field is for validation purposes and should be left unchanged.