To register online for the Super Conference, please fill out the form below.

To purchase discounted tickets for groups of 5 or more for $15 each, please call the Diabetes Foundation of Mississippi at 601-957-7878 with the names of your attendees.
Note: Fields marked with an asterisk (*) are required.

Contact Information

First Name*
Last Name*
Email Address*
Address*
Address Line 2
City*
State*
Zip*
Country*
Phone Number*

Order Summary

Date 04/25/24
Registration Options
If selecting Student or Group rate, please enter school & instructor
If selecting Group Rate, please enter Group Name -church, etc.

Please List the individuals attending the event
Guest 1
Guest 2
Guest 3

If your particular family combination is not one of the options, or you wish to purchase discounted tickets for groups of 5 or more, please call the Diabetes Foundation of Mississippi at 601-957-7878.

Credit Card Information

Card Type
Name as on Card*
Same As Contact
Card Billing Address*
Card Billing Zip*
Card Number*
Card Expiration Date* MMYY
Card ID (CVV2/CID) Number*
[What is the Card ID?]

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To register online for the Super Conference, please fill out the form below.

Contact Information

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Solving the Mysteries of Diabetes: Diabetes Super Conference