banner image

2018 Narrowing the Gulf Conference Registration Form

Narrowing the Gulf for Underrepresented Students in Postsecondary Education
19th Annual Conference

Co-sponsored by:
St. Petersburg College Center for Excellence in Teaching and Learning (CETL), SPC's Accessibility Services, SPC's Retention Services Department and Florida Association on Higher Education and Disability (FL-AHEAD)

April 5-6, 2018
St. Petersburg College EpiCenter
13805 58th Street North
Clearwater, FL 33760

Please fill out the following form to register for the 19th Annual Narrowing the Gulf Conference at St. Petersburg College.

Download the 2018 Program

*1
First Name
*2
Last Name
*3
Are you a member of the Association on Higher Education and Disability?
*4
Name as you would like it to appear on badge
*5
Title
*6
Organization
*7
Address
*8
City
*9
State
*10
Zip Code
*11
Phone
*12
E-mail address
*13
Registration fee
14
Payment method (Credit cards are not accepted for this conference.) 

St. Petersburg College Employer Identification #59-1211489
15

Purchase Order Details

(St. Petersburg College Employer Identification# 59-1211489)

16

Check Number Details

(St. Petersburg College Employer Identification# 59-1211489)

*17
Do you need special accommodations to participate in this conference? If yes, a representative from the conference will contact you to arrange accommodations.
 

If you have any questions or comments about this form, please contact Aimee Stubbs at Stubbs.Aimee@spcollege.edu or call 727-341-3398 Fax: 727-499-9023

St. Petersburg College is committed to equal access/equal opportunity in its programs, activities, and employment. For additional information visit www.spcollege.edu/eaeo/. St. Petersburg College is an Equal Opportunity Employer.