AIE Symposium 2019 Registration Please fill in the required fields below marked with *. **If your organization is paying for multiple attendees and wishes to pay by invoice, please do not complete this registration form. Contact Shelley McLean by email or phone: 902-423-8418. Last Name:* First Name:* Street Address:* City/Town:* Province/State:* Please select... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Postal/Zip Code:* Email:* Phone Number:* Organization:* Please indicate any special dietary requirements or restrictions: Please indicate any specific access requirements you may have: Continuing Education: Are you a BCBA/BCaBA requiring CEUs?* Please select... Yes No Are you a Speech-Language Pathologist requiring CEUs?* Please select... Yes No * I understand that refunds of registration fees cannot be provided, but I may identify a replacement if I am unable to attend the symposium. Registration fee includes nutrition breaks and lunch on-site. Early registration: $229 + HST (until March 15, 2019) Late registration: $249 + HST (after March 15, 2019) Ignore this form element. It is used to detect spambots.