Personal InformationHonorific (e.g. Mr., Ms., Mrs. Miss, Dr., Prof., Rev.)*Given Name*Middle NameSurname or Family Name – ALL CAPS*Full Name and Country To Be Listed On Name Badge and Program*Primary Email Address* Preferred WhatsApp Phone (include country and area code)*Institution/Organization*Title or Position*Note: Information regarding religious affiliation and position is not required; if you fill out these boxes you are consenting to our processing this personal data. This will be used only for keeping track of general religious distribution of ACLARS conference participants.Religious AffiliationReligious PositionRegistrationI have the following special needs (medical, mobility, allergies, other)I have the following special dietary requirements:LanguageIn which language would you prefer to speak/listen to the sessions?Notice: ACLARS can only fund French translation, though we are exploring options using cell phones and electronic translation, and wifi.Are you fluent in English?*YesNoGuest InformationPlease note: Guest travel and additional hotel room costs are paid by the guest and not by the conference organizers.Accompanied by spouse or guest?YesNoGiven Name of Guest/Spouse (name to be used on name badge)*Surname of Guest/Spouse (name to be used on name badge)*Will the delegate be sharing a hotel room with their guest or does the guest need a separate hotel room?*Shared Room, One Double BedShared Room, Two Twin BedsSeparate Guest RoomOtherIf you require a Certificate of Participation after the Conference please clearly specify the wording and information needed on the certificate. Yes, I require a Certificate of Participation and DO NOT need specific wording or information on my certificate. Yes, I require a Certificate of Participation and will need specific wording or information on my certificate. No, I do not require a Certificate of Participation. Please clearly specify the wording and information needed on the certificate.(I.e. Name, Institution, Presentation Title, Date, Other)I am willing to receive further communications from the organizers (e.g., program information, flight arrangements, etc.)* Yes No Please upload a high resolution headshot, or email it to [email protected]Max. file size: 20 MB.Please agree to the statement below.* I have uploaded or will email a high resolution headshot of myself. Please write a brief biography in paragraph form (Can cut and paste from another document)*ACLARS Terms and ConditionsView 2026 Terms and ConditionsPlease Agree to the Statement Below:* I agree to the above terms and conditions relating to the event Please Agree to the Statement Below: I give permission to be added to a Conference WhatsApp group for logistical purposes. CAPTCHAThis field is hidden when viewing the formDate DD slash MM slash YYYY
