Online Registration

"*" indicates required fields

Step 1 of 3

Name*

First Last

Agency / Affiliation

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

FL County

Phone (cell)

Email*

Would you like to join FSPC now and receive a reduced conference fee?

Would you like to be updated about Florida Suicide Prevention activities?

Yes

Would you like to volunteer with the Florida Suicide Prevention conference?

Yes

To volunteer for the conference (4 hours) and receive a 50% discount on your total registration fee, please contact Steve Roggenbaum ([email protected])

How Many Entries are you purchasing today?

Please enter a number from 1 to 25.

Choose the option that best suits you.

Would you like to attend a pre conference workshop Monday 8am - 12pm?

$25 for members and $35 For Non Members

Second attendee's Name

First Last

Second Attendee Type

Would The second person like to attend a pre conference workshop Monday 8am - 12pm?

Third attendee's Name

First Last

Third Attendee Type

Would The third person like to attend a pre conference workshop Monday 8am - 12pm?

Fourth attendee's Name

First Last

Fourth Attendee Type

Would The fourth person like to attend a pre conference workshop Monday 8am - 12pm?

Fifth attendee's Name

First Last

Fifth Attendee Type

Would The fifth person like to attend a pre conference workshop Monday 8am - 12pm?

Breakdown of Fees

FSPC Membership

Price:

Pre Conference Workshop member

Price:

PreConference Workshop non member

Price:

second Pre Conference Workshop member

Price:

Second PreConference Workshop non member

Price:

Third Pre Conference Workshop member

Price:

Third PreConference Workshop non member

Price:

Fourth Pre Conference Workshop member

Price:

Fourth PreConference Workshop non member

Price:

Fifth Pre Conference Workshop member

Price:

Fifth PreConference Workshop non member

Price:

Attendee Qty 1 member

Price:

Attendee Non Member

Price:

Second Attendee Member

Price:

Second Attendee Non Member

Price:

Third Attendee Member

Price:

Third Attendee Non Member

Price:

Fourth Attendee Member

Price:

Fourth Attendee Non Member

Price:

Fifth Attendee Member

Price:

Fifth Attendee Non Member

Price:

Presenter

Price:

Presenter Non Member

Price:

Second Presenter

Price:

second Presenter Non Member

Price:

Third Presenter

Price:

Third Presenter Non Member

Price:

Fourth Presenter

Price:

Fourth Presenter Non Member

Price:

Fifth Presenter Member

Price:

Fifth Presenter Non Member

Price:

Student member

Price:

Student non member

Price:

Second Student member

Price:

second Student non member

Price:

Third Student member

Price:

Third Student non member

Price:

Fourth Student member

Price:

Fourth Student non member

Price:

Fifth Student member

Price:

Fifth Student non member

Price:

Total

Comments

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Please Download a Copy of the 2025 Mail In Registration Form Here

2025-02_Suicide_Conf_Registration_Flyer_1125

Florida Suicide Prevention 2025 Conference

Online Registration

Breakdown of Fees