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SVIA Fall Forum Registration
All online registrations must be accompanied by credit card payment. Those wishing to pay by check cannot register online. If you wish to pay by check, please contact:
[email protected]
Email
*
Name
*
First
Last
Optional: CC Email
Please enter an additional email address to receive your confirmation notice and event notifications.
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Registration Details
Everything below here is for testing only and will not be visible when the form is live.
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Member Type
*
Options: Non Member, Consultant, Plan Sponsor, Service Firm, Value Program
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Board
*
Options: Yes, No
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Executive Committee
*
Options: Yes, No
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VP Discount
*
Options: Yes, No
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Voting Member
*
Options: Yes, No, NA
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Registration Date
*
MM slash DD slash YYYY
Registration ID
You are registering as a non-member.
This email is not in our member database. To continue registering as a non-member hit next, otherwise contact SVIA at
[email protected]
to change or add your email address to our member lists.
Contact Information
Company
*
Title
*
Phone
Cell Phone
Please provide a cell phone number in case we need to reach you while you’re traveling.
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Attendee Information
Are you new to SVIA conferences?
New attendees are welcome to join special networking events that help connect them with experienced industry members and other newcomers.
Yes
No
Would you like to register for a Stable Value 101 breakout session that covers the basics of stable value?
*
This breakout session is open to anyone who feels they may benefit, and will encourage Q&A.
Yes
No
Optional self-identification questionnaire
As part of our initiatives to measure the growth of the membership, we’d like to get a better picture of attendees, to ensure we continue creating inclusive events. Please answer some or all of the questions below, if you feel comfortable doing so; all responses are anonymous and will only be shared in aggregate.
How long have you worked in the stable value industry?
Please select an option
Less than one year
1-2 years
2-4 years
4-6 years
More than 6 years
What is your age?
Please select an option
18-25
26-35
36-45
46-55
56-65
>65
What is your racial and/or ethnic identity?
Of Hispanic/Latino origin
Not of Hispanic/Latino origin
American Indian or Alaska Native
Asian or Asian American
African, Black, or African American
Native Hawaiian or Pacific Islander
White
I do not wish to disclose
Which best represents how you currently identify your gender?
Agender
Female
Male
Non-binary
I do not wish to disclose
Do you consider yourself transgender?
Yes
No
I do not wish to disclose
Which best represents your sexual orientation?
Asexual
Bisexual
Gay
Heterosexual
Lesbian
I do not wish to disclose
Do you identify as a person with a disability?
With ‘disability’ defined under the Americans with Disabilities Act: https://adata.org/faq/what-definition-disability-under-ada
Yes
No
I do not wish to disclose
Have you served in the military?
Yes
No
I do not wish to disclose
Additional Information
Will you attend the SVIA Board of Directors meeting on Monday, October 5th from 2 – 4 PM?
*
SVIA’s Board of Directors’ meeting is a benefit of Association membership. Please be advised that attendance is limited to members of the Association.
Yes, I will attend.
No thanks.
Would you like to volunteer to be a Fall Forum Host?
*
We’re asking experienced industry members to help one new attendees navigate the conference by answering questions, showing them around, and introducing them to others at SVIA receptions. We’d really appreciate your help in making the association a more inclusive and welcoming environment!
We may not have a new attendee for every volunteer, so there is a chance that we won’t contact you to volunteer even if you have signed up.
Yes, I would like to volunteer.
No thanks.
For planning purposes, please list below any food allergies or dietary restrictions. SVIA advises you communicate any allergies directly to facility staff as well. Please leave blank if no special dietary restrictions apply.
Hotel Reservation
SVIA has reserved a limited number of rooms at the Fairmont for Fall Forum attendees at a special rate of $379.
Room reservations will be made directly with the hotel using a special link that will be sent along with the confirmation email when you finish registering for the conference.
To obtain SVIA’s rates and ensure you have lodging at the Fairmont, please make sure you make your reservation immediately after signing up for the conference.
Your value program discount has been incorporated and applied automatically.
Fall Forum Registration Fee
*
Price:
Discount Code
If you were provided with a discount code, please enter it here.
Total
Payment
Credit Card
*
Card Details
Cardholder Name
Billing Address
*
Same as previous
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
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
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Confirmation
Please review your responses below and then hit submit to finalize your registration.
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