Housing is a Human Right conference Registration Form Housing As a Human Right Registration Date : October 09, 2024 Time: 8:00 am - 6:00 pm Location: DoubleTree by Hilton Somerset 200 Atrium Drive, Somerset, NJ Attendee First NameAttendee Last NameEmailAttendee Title (optional)Phone Affiliation (Company, Association, Organization, University, etc.). Payor (person or organization responsible for payment)- Select -AttendeeAffiliationOther (enter below)Other billing entityBilling AddressCityStateZip CodeCountryCountyAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweHow did you hear about the Housing As a Human Right Conference? Monarch Website Monarch Staff Member Friend/Colleague Monarch E-blast OtherOther: Please specifyWhat sector are you involved in? Please select all that apply Affordable Housing Development Homeless Planning Public Policy Service Provider Construction Related Field Municipality or Governmental OtherOther: Please specifyWhat area are you primarily interested in?- Select -Housing DevelopmentHomeless PlanningPolicyDataPlease indicate any dietary restrictionsPlease indicate any accessibility accommodationsPlease indicate your preferred pronounsPlease check to indicate agreement with the Waiver of Liability and Assumption of Risk Statement linked below. I accept the risks outlined in the risk statementWaiver of Liability and Assumption of RiskPlease note that photographs will be taken at the conference and by attending you agree that photos of you may be used by Monarch for marketing or other purposes. If you have any concerns about this, please contact Monarch at conference@monarchhousing.orgScholarship Opportunities Monarch Housing Associates has established a scholarship program to allow individuals who are currently experiencing homelessness (or have formerly experienced homelessness within the last five years) to fully participate in the conference if they cannot afford to cover the cost of the conference. To request one of these scholarships, please email conference@monarchhousing.org.Registration Fee Individual - $50If you are unable to attend, but would like to still support the conference, please do not register as we expect the conference to be at capacity. You may instead make a donation of any amount instead. Please enter the amount below.If you have a code, please enter it in the below (please note that you still need to select the individual registration fee above):Apply CodeNo payment items have been selected yet *If you require an invoice in order to pay by check, please select the "Mail a check" option and submit your registration. We will then send you an invoice for your payment.*Payment Method Pay with PayPal Mail a check / Offline PaymentDo you need an invoice in order to process the payment? Yes NoIf paying by check, please make payable to Monarch Housing Associates and mail to: Monarch Housing Associates226 North Avenue WestCranford, NJ 07016Complete Registration and Proceed to Payment
