Emerging Contaminants in the Environment Conference Registration / New Form (page 1/2)

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Complete the information below to register for ECEC24.

Note: The registration form does not save your information. Registration is complete after the payment step. This form does not allow multiple registrations on one payment.

First Name*

Last Name*

Organization Name*

Occupation Title*

What country are you from?*

Email (please enter the email you use for professional purposes)*

Please select your registration option.*

Virtual Conference Registration - $100

Student Virtual Conference Registration - $50

Please indicate any accommodations you might need at the conference.

Please select the top contaminant category for which you are most interested in attending the live conference sessions.*

Microplastics

PPCPs

PFAS

Other

ECEC24 is able to offer 2 continuing education units (20 professional development hours/contact hours). Do you need a certificate of completion showing 2 CEU earned?*

Yes

ECEC24 will be recorded and archived online. By registering for the conference, you grant the conference organizers permission to use your likeness in the recordings. (more details below)*

I agree

I consent to the use by The Board of Trustees of the University of Illinois (“University”) of my image, voice, or both described below, in (1) the video, photograph, or audio recording described below; and (2) any video, photograph, or audio recording reproduced either in whole or in part from the video, photograph or audio recording described below: regardless of whether these materials are used for fundraising, advertising, publicity, or any other purpose on behalf of either the University or its Foundation. I warrant that I have the full right and authority to grant this consent. In addition, I waive all claims to compensation or damages based on the use of my image or voice, or both, by either the University or the Foundation. I also waive any right to inspect or approve the finished photograph or video or audio recording. I understand that this consent is perpetual, that I may not revoke it, and that it is binding on me, my heirs and assigns. I warrant that I am at least 18 years of age and that I am competent in my own ability to consent, or that I am the parent or legal guardian authorized to consent on behalf of a person under age 18. I further attest that I have read this consent and fully understand its contents.

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