Between Old Worlds and New
Online Registration Form

Required fields are marked with an asterisk (*).

Your Information
Name (as you would like it to appear on your nametag): *
Instrument(s) (as you would like it to appear on your nametag):
Organization and/or location (as you would like it to appear on your nametag):
Pronouns (as you would like them to appear on your nametag):
Email: *
Mobile Phone: *
Billing Address: *
Billing Zip/Postal Code: *
Billing Country: *
We will add your name tag details to a conference directory that will be included in the welcome packet (no email or mobile phone numbers will be included). If you do not wish to be part of the directory, please click the checkbox below.	I do not wish to be part of the conference directory
Registration Options

If you have a dietary restriction, please indicate here:
Donation Please consider making a gift in support of the Westfield Center, the Between Old Worlds and New conference, or for student travel costs:
Westfield Center general fund:	$
Between Old Worlds and New conference budget:	$
Donation in support of student attendees’ travel and lodging	$
If you have made a donation, would you like your name to appear in the program book in the donor section?	Yes No
Student Financial Support
We would like to provide financial support for student attendees’ travel and lodging. If you are a student attending the conference who would like to apply for financial support, please provide a brief description of anticipated costs and how much funding you are seeking. We cannot guarantee to fund the amounts requested––support will be contingent upon donations––but will grant funding to the extent possible.
Payment Info

Total Cost (USD)
$0.00

Questions? Problems? Contact info@westfield.org. No credit card information is received or stored by the Westfield Center.

Between Old Worlds and NewOnline Registration Form

Your Information

Registration Options

Donation

Student Financial Support

Payment Info

Total Cost (USD)

Between Old Worlds and New
Online Registration Form