First Name *

Last Name *

Email *

Phone *

Are you planning on attending in person or virtually? *
- Select Option In person Virtually

A zoom link will be provided in the confirmation email!

Prior to the keynote, we are happy to be hosting a public reception from 5 - 6 pm in the Meijer Regency Room!

Will you be attending the public reception prior to the event? *
- Select Option Yes No

How did you hear about this event? *
Email
Postcard
Social Media
GVSU Flyer / Laker Hub Slide
Word of Mouth
Experience Grand Rapids
Not listed Please specify a value for How did you hear about this event?

What is your affiliation with the Hauenstein Center? Check all that apply. *
GVSU Student
GVSU Faculty / Staff
GVSU Alumni
CLA Fellow Candidate
Hauenstein Center Member
West Michigan Community Member
Not listed Please specify a value for What is your affiliation with the Hauenstein Center? Check all that apply.

First Name *

Last Name *

Are you planning on attending in person or virtually? *
- Select Option In person Virtually

A zoom link will be provided in the confirmation email!

Prior to the keynote, we are happy to be hosting a public reception from 5 - 6 pm in the Meijer Regency Room!

First Name *

Last Name *

Are you planning on attending in person or virtually? *
- Select Option In person Virtually

A zoom link will be provided in the confirmation email!

Prior to the keynote, we are happy to be hosting a public reception from 5 - 6 pm in the Meijer Regency Room!

First Name *

Last Name *

Are you planning on attending in person or virtually? *
- Select Option In person Virtually

A zoom link will be provided in the confirmation email!

Prior to the keynote, we are happy to be hosting a public reception from 5 - 6 pm in the Meijer Regency Room!