Constellations Convergence Registration
The 2019 Southern Constellations Convergence is free to attend but registration is required. The first 50 registered participants will have lunch provided by Elsewhere (vegetarian options available). For more information visit:

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Email address *
Email Type *
Prefix *
Dr., Ms., Mr., Mx., etc.
Your answer
First Name *
Your answer
Middle Initial
Your answer
Last Name *
Your answer
Name Suffix
II, III, jr, etc.
Your answer
First Name Pronunciation *
Phonetic spelling or representation of vocal sounds that express name pronunciation. (ie. AHN-na; ee-in; NAH-dya)
Your answer
Last Name Pronunciation *
Phonetic spelling or representation of vocal sounds that express name pronunciation. (ie. huff; bone-steel; GRAHN-day)
Your answer
Your answer
Ethnicity / Race
Your answer
Your answer
Pronouns *
She/her/hers, he/him/his, and they/them/theirs.
Your answer
Affiliation *
Primary Association: 'Organization/Institution Name' if applicable, 'Freelance,' or 'Independent.' Ex: Rhode Island School of Design (R.I.S.D)
Your answer
Affiliation Title *
Primary Title: Student, Executive Director, Visual Artist, Performance Artist, Multimedia Artist, Graphic Designer, etc.
Your answer
Phone Number
If international, write the complete number starting with the Country Code. Ex: (336) 907-3271 ; (+33-1) 22-33-44-55
Your answer
Phone Number Type
Address *
Street address or P.O. box number + City or town, principal subdivision such as province, state, or county and postal code. This will not be shared with anyone and will only be used by Elsewhere.
Your answer
Address Type *
If address is currently unavailable, choose "Other."
Access Needs
Ex: Lactation room, service animal, wheelchair lift, caregiver, etc.
Your answer
Any personal or organizational website(s) you want to include?
Your answer
How did you hear about the Convergence? *
Your answer
Do you want to share you info with Convergence Participants? *
For the convergence, we will compile a list of all participants, their email addresses, and websites to facilitate networking! No other information provided within this registration form will be shared.
Would you like to receive Elsewhere's monthly e-newsletters? *
A copy of your responses will be emailed to the address you provided.
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