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Privacy Note: Unless permission is explicitly granted by you, the information collected in this form is only accessed by Start Proud and is not shared outside the organization. Your information is solely collected to better understand the audience we serve in order to improve future Start Proud events and initiatives. For more information please see our Privacy Policy.

Personal Details

Your Name, Pronoun and Institution will be printed on your nametag.

First Name:*
Preferred First Name (for your nametag):*
Last Name:*
Contact E-mail:*
I am a*
Preferred Pronoun:*
Gender Identity:*
Other Gender Identity:*
Sexual Orientation:*
How do you act as an Ally for the LGBTQ+ community?*
Dietary Restrictions:
Current Position*
Current Place of Employment:*
Designations Held:
Current Institution:*
If Other, enter Institution:*
Current Program:*
Major/Area of Concentration:*
Expected Graduation Month:*
Expected Graduation Year:*
Career Objectives - First Choice:*
Career Objectives - Second Choice:
How did you hear about The Conference?*
%91 - Name of Student Ambassador that referred you:%
Have you attended The Conference in the past?*
Have you or anyone you know been successful at securing an interview, a job, mentorship opportunity, or a coffee chat?
Why are you attending The Conference?*
What companies/organizaions would you like to see at the conference? if any in particular, please specify*
Resume Upload

Some of our sponsors are recruiting! If you upload your resume we will share your name, email, current institution, expected graduation date, career objectives and resume with our sponsors. Acceptable formats are doc, docx and pdf.

Resume Upload:
Discount Code

If you have a discount code for conference registration, please enter it here.

Discount Code:
Ticket Selection
%67 - Regular Ticket - $100%
Friends and Family Discount Ticket (-15$) - $85
FREE Ticket - $0:
Raffle Winner Ticket - $0:
Special Ticket - $0:
Bootcamp Discount Ticket (-20$) - $80
Student Group Discount Ticket (-25$) - $75

Start Proud does not store credit card information.
Payments are processed securely by Stripe.

Card number:*
Expiration month:*
Expiration year:*

By submitting your registration you authorize Start Proud to contact you by email regarding the event.

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