Registration for the 2022 CEDAS Annual Meeting & Fall Social

(* Denotes Required Fields)

Contact Information

Name *
Organization *
Address Line 1 *
Address Line 2
City *
State *
Zip *
Business Phone *
Business Fax
E-mail Address *

Attendee Registration

Please choose the quantity for each:
CEDAS Member * Quantity: Cost: $50.00
Future Member * Quantity: Cost: $65.00
Please list the names and emails for each person you are registering.
Please indicate if you need an invoice or receipt:

Payment Information

Payment Method
Make your check payable to CEDAS and then please mail it to:
Alison Geisler
545 Long Wharf Drive, 8th Floor
New Haven, CT 06511
If you require an invoice to process your check, please email
(All credit card information must be filled out completely to make a payment.)
Card Type:
Card Number:
Name on Card:
Verification #:
Expiration Date: (MM/YYYY)
Billing Address:
City   State   Zip:

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