Vermont

EXTERNSHIPS 12 CONFERENCE 2024

Registration Form

The New England Externship Consortium (NExt) is thrilled to host the 2024 Externship Conference (X12) in Boston this October 17-19, 2024. Cost is $250 per person for in-person attendance if registered by September 20th, or $50 per person for virtual attendance. Late registration for in-person attendance is $300. Submit the form below to register; once you submit your registration, click the Pay Securely Online link to use our online, secure form. Please contact Beth Locker at BLocker@vermontlaw.edu or NKilloran@vermontlaw.edu at NKilloran@vermontlaw.edu if you have questions or need more information.

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If you have already submitted this form, make sure not to pay twice!

First Name *

Last Name *

Pronouns

Institution/Affiliation

Position(s)/Title(s)

Email *

Phone

Attendance Location *

Payment Amount

Do you plan to attend the Welcome Reception, 5:30-7pm, Thursday, October 17 on the Courtyard Marriott Rooftop Deck? *

I am a new clinician (in my first five years of clinical teaching).

The conference planners intend to compile a list of conference registrants that will be shared with attendees. If you do not want your name and contact information shared, check here.

Please let us know if you have any accessibility requirements or special needs that we should be aware of to support your full participation in Externships 12. This may include but is not limited to physical disabilities, dietary restrictions, sensory sensitivities, or any other accommodations you may require. We are committed to making this event inclusive for all attendees and will do our best to accommodate your needs.

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