2024 CONVENTION REGISTRATION FORM

Illinois Psychological Association 2024 Annual Convention

November 7 & 8, 2024

If paying by check, click here for a copy of the 2024 Registration Form to fill out and mail in, and to view after early bird pricing information. Otherwise, please fill out the form below.

Click here for a copy of the 2024 Convention Brochure.

Are you an IPA member?
Yes No

First Name

Middle Name or Initial (optional)

Last Name

Highest Degree

Pronouns you would like on your name badge

Organization/Affiliation

Address1

Address2

City

State

Zip

Phone

Email Address

SELECT REGISTRATION CHOICES

THURSDAY AND FRIDAY PROGRAMS (Includes Lunch)
Non-Members: $385

THURSDAY PROGRAMS ONLY (Includes Lunch)
Non-Members: $250
Students who are not IPA Members: $55

FRIDAY PROGRAMS ONLY (Includes Lunch)
Non-Members: $250
Students who are not IPA Members: (no lunch) $45
Students who are not IPA Members: (lunch included) $55

TOTAL DUE:

I prefer a vegetarian lunch

Credit Card Information

First Name on Credit Card

Last Name on Credit Card

Credit Card Number

Security Code

Expiration Month

Expiration Year

YOUR PROGRAM CHOICES: Check the number of each program you plan to attend on Thursday and Friday. This information will help determine meeting room size. Refer to program numbers listed with program titles.

Thursday: A.M. 1 2 3 4 5 6 7 8

Thursday: P.M. 9 10 11 (cancelled) 12 13 14 15 16 17 18 19 20

Friday: A.M. 21 22 23 24

Friday: P.M. 25 26 27 28 29