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Prefix:
First Name*
Last Name*
Name to be displayed on badge
Please input how you would like your name to be printed on your convention name badge. If no response is received, the first and last name given will be printed on the badge.
E-mail*
Pronouns (e.g., she/her/hers, he/him/his, they/them/theirs, etc.)
Position (e.g., doctoral student, clinician, assistant professor, etc.)
Affiliation
List the university/institution you are affiliated with.
Mentor/Mentee
Would you be interested in being sent more information about possibly serving as a mentor at this year's AAPA convention mentor/mentee event?
Are you registering another attendee?*
You can register one additional person per process. If you'd like to register additional people, please complete this process again upon completion.
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