Speaker Series Registration Form

Please complete the form below. Required fields marked with an asterisk *

NOTE: REGISTRATION WILL CLOSE AT 12:00 PM ON THE DATE OF THE EVENT.

PLEASE COMPLETE A FORM FOR EACH ATTENDEE.

2025-26 Speakers

Contact Information

First Name*

Answer required for "First Name"

Last Name*

Answer required for "Last Name"

Email Address: This is the address to which we will use to communicate reminders or changes*

Answer required for "Email Address: This is the address to which we will use to communicate reminders or changes"

Please choose the event(s) below for which you would like to register*

Answer required for "Please choose the event(s) below for which you would like to register"

Tim Odegard, Ph. D. (in person on November 12, 2025)

Please select the category that best describes you:*

Answer required for "Please select the category that best describes you:"

DVFriends parent/guardian

Non-DVFriends parent/guardian

DVFriends faculty or staff member

Non-DVFriends Education Professional (teacher, administrator, counselor)

Psychologist/psychiatrist

DVFriends Alum parent/guardian

Other:

How did you hear about this event?*

Answer required for "How did you hear about this event?"

Email from DVFriends

Social Media (Facebook, Instagram, LinkedIn)

DVFriends website

From a friend

Non-DVFriends email or website

NPR/WHYY Ad

Other:

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