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TYPE OF REGISTRATION

Please Choose One Professional Registration ($149) Student Registration * ($99) KSN Student On/After June 21st ($200)
Please choose a registration type.

* If registering at the "Student Registration" rate, please forward proof of student status, such as current course registration or confirmation from your school on its letterhead, to our Director of Communications and Outreach via email at cblack@okcu.edu or by fax to (405) 208.5914.

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REGISTRANT INFO

First Name:
<-First Name is required.
Last Name:
<-Last Name is required.
Credentialing Initials:

Title:

Employer or School:
<-Employer/School is required.
Address:
<-Street Address is required.
City:
<-City is required.
State:
--- 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 Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming <-State is required.
Zip:
<-Zip is required.
Phone (w/ area code):
<-Phone is required.
Email:

Verify Email:

<-Emails must match.