The Association of Clinical Research Professionals

ACRP Continuing Education Grants to Support DEI Scholarship Registration Request Form

This form is intended for recipients of the Continuing Education Grants to Support DEI Scholarship who have been designated to receive a complimentary registration for the ACRP 2024 conference.

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Name(Required)

First Middle Last

Email Address (Must match your ACRP account email address. If you do not have an ACRP account, please create one before proceeding.)(Required)

Are you also a ACRP 2024 exhibitor or speaker?(Required)

Yes- exhibitor

Yes- speaker

Yes- Both an exhibitor and speaker

Billing Information

If you have requested any registration items that require additional payment we will reach out with an invoice. Please provide billing contact information below. Please note that completing this form does not automatically register you for the conference. Our team will follow up with an official confirmation once you are registered.

Billing Contact Name

First Last

Billing Contact Email

If you have more than one billing contact, or any additional contact people for this registration, please list those email addresses below.

Housing

If you have not yet booked a hotel room for ACRP 2024, please go to LINK to book your room.

Comments/Questions

If desired, please share any additional information related to your registration request.