Cancellation Form

Cancellation requests from registrants must be made by completing the online Cancellation Form below. No cancellation or refund requests will be accepted by phone or email. A total refund of paid registration fees, minus a $100 processing fee, will apply to all cancellations submitted by September 30, 2021.

No refunds will be issued after September 30, 2021.

Attendee Information
Attendee Name(Required)
First Last
Please enter the first and last name of the registered attendee who will be cancelling their 2021 EMDRIA Virtual Conference Registration.
Attendee Email(Required)
Enter Email Confirm Email

Please enter the email address of the registered attendee who will be cancelling their 2021 EMDRIA Virtual Conference Registration.
Reason for Cancellation Request
Reason for Cancellation Request(Required)
- Scheduling Conflict
- Financial
- Illness
- Other
Please select the most appropriate option(s) above for your reason to cancel your registration.
Phone
This field is for validation purposes and should be left unchanged.

Cancellation Form

Attendee Information

Reason for Cancellation Request