NGEDA Membership Form

NGEDA State Association Conference Registration

This conference registration form is for state associations or individual non-corporate members only (and their guests). Corporate members will find their registration form under the "Corporate Members" tab.

Company

This field is for validation purposes and should be left unchanged.

State Association(Required)

Name(Required)

Prefix First Last

Title or position

Contact Phone(Required)

Contact Email(Required)

The email address you are most likely to check regularly

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP Code

State Association Membership Details

States must renew their NGEDA membership annually prior to registering for the NGEDA Conference. Please ensure your state membership invoice has been paid prior to registering for the conference. Please provide the names of the 4 active members included with your NGEDA membership.

Active member #1(Required)

Active member #1 title(Required)

Active member #1 email(Required)

Active member #2

Active member #2 title

Active member #2 email

Active member #3

Active member #3 title

Active member #3 email

Active member #4

Active member #4 title

Active member #4 email

Additional Active Memberships(Required)

None

One - $30 - Active Membership

Two - $60 - Active Memberships

Three - $90 - Active Memberships

Four - $120 - Active Memberships

Additional Active member #1(Required)

Additional Active member #1 title(Required)

Additional Active member #1 email(Required)

Additional Active member #2(Required)

Additional Active member #2 title(Required)

Additional Active member #2 email(Required)

Additional Active member #3(Required)

Additional Active member #3 title(Required)

Additional Active member #3 email(Required)

Additional Active member #4(Required)

Additional Active member #4 title(Required)

Additional Active member #4 email(Required)

Alumni Individual Membership Dues

$20 - Alumni Individual Membership

Alumni Individual member #1(Required)

Alumni Individual member #1 title(Required)

Alumni Individual member #1 email(Required)

2027 NGEDA Conference Registration

Please provide conference registration details below for members and guests.

2027 NGEDA Conference Registration(s)(Required)

Badge Name of First Attendee(Required)

Badge Name of second attendee(Required)

Badge Name of third attendee(Required)

Badge Name of fourth attendee(Required)

Badge Name of fifth attendee(Required)

Badge Name of sixth attendee(Required)

Total Amount

Credit Card