The 2023 Inclusion Summit | September 28-29

Personal Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• Please list any accommodation and/or dietary needs by September 8. Requests after that date are not guaranteed.

• Promo Code

  Enter Code: Apply

• Fee

  Type	Fee
  In-Person Rate thru September 8 or sold out	$299.00
  Virtual Rate thru September 18	$199.00

Attendee Information

• *

  What is your leadership role?

  • President/CEO
  • Vice President
  • Sr Level
  • Director
  • Manager
  • Other
• * What industry do you work in?
• *

  Will you attend the in-person Networking Social immediately after Thurs, 9/28 closing keynote?

  • Yes
  • No
• *

  Which organization are you or your company affiliated with?

  • Center for Disability Inclusion
  • DEI Consortium
  • KC Chamber
  • NAAAP-KC
  • None

Badge Information

• * Badge Name:

Business Information

• * Company:
• * City:
• * State: --Choose-- 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 -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * Phone:
• * Job Title:

Guest Information

You may add a maximum of 10