Registration

A huge thank you goes to Transcribing Mariners for their donation to help reduce the costs of our Meal Tickets by $50! Meal tickets are available for purchase separately for those who wish to dine on-site. The full meal package includes two lunches and two dinners for a total of $175. Please note that breakfast is included with your hotel stay for guests lodging at the conference property. 

The schedule has changed so that all attendees can attend the General Sessions/Keynotes.

Exhibitors, use the form below. There is a special section for you to complete.

Please enable JavaScript in your browser to complete this form.

This form is good for both attendees and exhibitors. Exhibitors have a special additional section at the bottom of the form to complete.

Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Level of Vision *

• Sighted
• Legally Blind/Partially Sighted
• Totally Blind

Preferred Conference Program Format *

• Braille
• Electronic
• Large Print

Preferred Method of Communication

• Phone
• Text
• Email
• Snail Mail

Birthdate

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Gender

• Male
• Female

Mobility

• White Cane
• Guide Dog
• Sighted Guide
• Wheelchair/Scooter

Allergies (especially food allergies) or other health issues

Cause of Blindness/Eye Disease

How did you hear about the conference?

I am interested in group transportation if possible. This may be a chartered bus/van and I understand this incurs an additional fee.

• Yes
• No

I need an assistive listening device

• Yes
• No

I am a Personal Assistant or SSP

• Yes
• No

I'm an Assistant/SSP for:

I am a Volunteer

• Yes
• No

I would like to order a conference t-shirt for $22. Adult sizes only (add $1 for 2XL, $2 for 3XL) choice. This will be invoiced separately closer to the conference time.

• Small
• Medium
• Large
• XL
• 2XL +$1
• 3XL +$2

I am purchasing Meal Ticket package - $175. (2 lunches, 2 dinners, breakfast is included with the hotel stay).

• Meal Ticket Package

Special Dietary Need (if purchasing meal ticket)

• Vegetarian
• Gluten

I am interested in Pre/Post Conference Activities (cost varies and is not included in conference costs)

• Bass Pro Shop
• Magnolia Soap or Candle Making Class
• Rose District Shopping
• Exotic Animal/Zoo Experience

For Exhibitor Sponsors

If you are an exhibitor sponsor, please continue to complete the information below and hit the submit button at the very bottom of this page.

Company Name

Name(s) of those manning the booth

Company Phone

Website / URL

Company Address

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Level of Sponsorship

• Platinum
• Gold
• Silver
• Bronze
• Marketing/Goodie Bags

Add on's

• Extra Table
• Electricity
• Meal Tickets

Are you willing to donate an item for the auction raffle?

• Yes
• No

Will you be sending Marketing Material or SWAG to be stuffed into the Goodie Bags?

• Yes
• No

I will need ACVREP CEU credits

• Yes

You will be taken to the payment portal after hitting the submit button. From there, choose the appropriate item(s) and will be added to your shopping cart to check out from there.

Submit