2021 FAST Forward Together Global Summit & Gala
Hilton Austin 500 E. Fourth Street Austin, TX 78701, US & Virtual
Please complete the following for your registration:
First Name
Last Name
Email
Phone Number
Address Line 1
City
State
Zip / Postcode
Country Representing
Preferred Language
How will you be attending this event?
Select
In person
Virtually
Both/other/not sure yet
Please select your relationship to Angelman syndrome
Select
Parent
Caregiver
Grand Parent
Sibling
Scientist
Industry
Sponsor
Other interested party
If you selected parent, grandparent, caregiver, sibling, please provide: Name of individual with AS (first only)
If you selected parent, grandparent, caregiver, sibling, please provide: Year of birth of individual with AS (YYYY)
If you selected parent, grandparent, caregiver, sibling, please provide: Genotype of individual with AS (Deletion, Mutation, UPD, ICD, Mosaic)
Select
Deletion
Mutation
ICD
UPD
Mosaic
If you would like to stay up to date with event announcements as well as FAST research news and organization updates throughout the year, please check 'opt in'
Opt in
Facebook Profile Name (or link)
Will this be your first summit? If not, how many have you attended?
How did you hear about the FAST Summit?
Select
Website
Facebook
Instagram
Friend
Family member
Prior attendee
Preferred seating partners if attending Gala.
Please let us know of any food allergies
If you are having trouble uploading your proof of vaccination or doctor’s note please e-mail it to our
Covid Compliance Officer
.
