Faculty Registration — Public Theology & Public Policy Conference

Conference faculty & Speaker Registration

Name

As issued on your government ID

First Name

Last Name

Phone/Text

Country

(###)

###

####

Email

Date of Birth

MM

DD

YYYY

Job Title/Position

Organization/Affiliation

Pronoun

TRAVEL & ACCOMMODATIONS

Do you require travel and hotel accommodations to participate in the conference?

Preferred Departure Date

MM

DD

YYYY

Preferred Departure City

Preferred Return Date

MM

DD

YYYY

Preferred Return City

CONFERENCE REGISTRATION

Please indicate which days you plan to stay and participate in the conference. We would love to have you!

Conference Days

Sunday, April 7

Monday, April 8

Tuesday, April 9

Please list any requests / special accommodations related to your travel and particpation

Thank you for your participation in our inaugural conference. Please take a brief moment to complete your registration by uploading your official headshot and abbreviated (1-2 paragraph) biography no later than March 15, 2024.

Upload Photo + Bio