Registration Information * required field. Last/Family Name: * First Name: * Name to print on badge: * Email Address: * Contact Phone Number: Affilliation/Employer: Job Title: Are you a registered speaker at this conference? Yes No Are you a currently enrolled student at a college or university? Yes No Are you a licensed health professional (Physician, PA, Pharmacist, etc.)? Yes No Are you a researcher? Yes No Do you want to be included on the CORE Network mailing list? Yes No After the conference, can we contact you with brief follow-up questions? Yes No We hope to have snacks and drinks available throughout the conference. Please describe any dietary restrictions. If you'd like any specific questions about cannabis to be addressed at the conference, please list them here. (A consolidated list will be provided to the speakers) If you were given a coupon code, please enter it here: Please have payment card or paypal account information ready.