MSU CA Clinic

Register Online

Required fields are indicated with an asterisk (*)

Registrant Information

* First Name

* Last Name

Company/Institution

* Address

Addt'l Address

* City

* State

* Zipcode

* Phone Number

* E-mail If you supply an e-mail address, a receipt for your registration will automatically be sent to that account. An e-mail address is required to pay using a credit card.

Registration Information

* I would like to register for this event

I give my permission to have my contact information shared with sponsors. * Yes No

Special Dietary Needs: If you indicate an allergy, please specify if it's ingested or airborne. Please provide as much information as possible about your restrictions so that we can appropriately meet your needs.

Contact Information

For information, contact Randy Beaudry at 517-353-0303 or beaudry@msu.edu and Lindsay Brown at brow1111@msu.edu.