Media Conference Registration Form

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Media Conference Registration Form

Media Registration Form

Members of the media must register to attend ASPPA's conferences and webcasts.

Media registrations are complimentary but subject to approval by ASPPA's Director of Media Relations.

NOTE: Items in RED below are required in order to properly process your registration for the conference(s) you wish to attend.

Which Conference do you wish to attend?
If you selected "Webcast", please indicate the date and title of the webcast:
Name
Badge Nickname
Title ASPPA Member? Yes No
Company
Street Address/PO Box:
City State Zip
Phone Fax
Email
Media Outlet Website:

Note: Information listed above for nickname, company, city and state will appear on your conference badge exactly as stated. Your name, address and phone number will also appear in the attendee list.

Role (Please choose the MOST applicable description.)

If you chose Other , please describe your role:

Subjects Covered (e.g. Beat) (Please choose the MOST applicable description.)

If you chose Other, please describe your subject(s):

Media Outlet Type (Please check the MOST applicable description.)

If you chose Other, please describe your outlet:

Media Outlet's Audience (Please check the MOST applicable description.)

If you chose Other, please describe your audience:

Outlet Circulation/Viewership (Please check the MOST applicable description.)

If you chose Other, please describe your current circulation/viewership:

Attach a link to your most recent story (article / post):

If you require special needs or dietary requirements, please specify below:

Kosher Vegetarian Other

If you have any questions, please contact Melinda Semadeni, Director of Media Relations, at:

Tel: 703.516.9300
Fax: 703.516.9308
Email: msemadeni@asppa.org

Event Calendar

[View All]

ACOPA Advanced Actuarial Conference
June 4 - 5, 2012
Boston, MA

Women Business Leaders Forum
June 11 - 14, 2012
Charlotte, NC

Great Lakes Benefits Conference
June 21 - 22, 2012
Chicago, IL

Northeast Area Benefits Conference
July 9 - 10, 2012
Boston, MA / New York, NY

Western Benefits Conference
July 15 - 18, 2012
Seattle, WA

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American Society of Pension Professionals & Actuaries
4245 N. Fairfax Drive. Suite 750 | Arlington, VA 22203 | P. 703.516.9300 | F. 703.516.9308

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