RDs of Color Entrepreneurs Summit Registration- Payment Plan Agreement ApplicationAtlanta, GA | March 27-29, 2020 First Name * Last Name * Email Address * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### Is this is your * Home Number Mobile Number Work Number Thank you for completing your application. We will follow-up within two business days with your Payment Plan Agreement Form. Please do not hesitate to contact us at registration@diversifydietetics.org if you have any questions.