2025 Professional Conference Registration Form

* Required fields

Name *

The name under which you register will appear on your name tag.

Pronouns

This will appear on your name tag.

Email Address *

Please provide your professional (rather than personal) email address, preferably one provided by your institution, unless you are attending as a MAP or a friend or family member of a MAP. We need this to contact you.

Dietary requirements, if any (e.g., vegetarian or vegan)

Evening events you plan on attending

Your response is not a commitment, but will assist us in our planning.

Friday evening meet-and-greetSaturday evening social eventNeitherUnsure

Nights for which you plan to reserve a discounted guest room at the conference hotel

Your response is not a commitment, but will assist us in our planning.

Friday nightSaturday nightNeither nightUnsure

If interested in serving as a presenter, panelist, or discussion moderator, enter name of session here.

Click here to see a list of session names in a new tab or window.

Which of the following are you registering as? *
Professional, researcher, or educatorGraduate studentMAPFamily member or friend of a MAPOther

Institutional or company affiliation *

Online professional profile if you have one

Providing a link to an institutional profile that lists your email address will facilitate your registration, especially if your email address is not provided by an institution.

Due to the increased expenses of a larger conference venue, this year we need to charge MAPs a registration fee of $25 per day. MAPs can request a waiver of this fee if their financial situation would otherwise prevent them from attending.

For purposes of anonymity, please note that the required "Billing Details" fields on the payment checkout page will not be checked if payment is submitted by mail or money order. While we do not require accurate information about your legal name or address to process this payment type, please be sure to enter an email address where we can reach you.

Waiver of registration fee for MAPs

Yes, I am a MAP and need to have my registration fee waived.

Have you attended an in-person B4U-ACT workshop or conference before? *
YesNo

As a MAP or friend or family member of a MAP who has not attended an in-person B4U-ACT workshop or conference before, we need you to provide a reference: someone trusted by B4U-ACT who can vouch for you. This can be a long-time B4U-ACT volunteer, a previous workshop attendee, a therapist or researcher in our network, or someone who has otherwise worked with us and gotten to know us well over time. If you are a MAP, you can also use a therapist whom you see as a client, in which case please have them email us at confreg@b4uact.org; their email should identify you as their client, contain a link to their online institutional profile, and state that they would have no concerns about your interactions at the conference.

Reference Name *

Reference email address *

Reference's relationship to you *

Reference's relationship to B4U-ACT

Vetting Process

After your reference is checked, we'll contact you to schedule a time to meet with you online before we can accept your registration. You are not required to submit payment until your registration has been accepted.

Additional comments or information