GSA Profile Creation Form

To register for the GSA Annual Scientific Meeting, you must have an account with The Gerontological Society of America. If you have previously been active with GSA, you should have an existing account. Click on the search for existing profile. If you have an existing account, your information will pre-populate below.

If you do not have an account, you will first need to create one. Please complete all the fields marked with an asterisk (*).

CAUTION: Edits made to existing profiles will also change your record in the GSA member database.
Basic Information
Prefix *
First/Given Name *
Middle Initial
Last/Family Name *
Suffix
Degree To select more than one degree, please hold the CTRL button while making your selection.
Affiliation Information
University/Organization *
Department
Title/Position
More Affiliation Information
Section/Area of Work *
Discipline *
If Other, please specify
Institution Type *
If Other, please specify
Function *
If Other, please specify
Contact Information
Address Type *
Mailing Address *
Mailing Address Cont.
City *
State/Province (required for US or Canada)
Zip/Postal Code (required for US or Canada)
Country *
Work Phone * ex. (555) 555-5555
Mobile ex. (555) 555-5555
Fax ex. (555) 555-5555
Email *
Student Information *required for students only
  I wish to participate as a student.
Academic Advisor's Name
Academic Advisor's Email
Optional Demographic Information
Date of Birth (mm/dd/yyyy)
Race
Ethnicity
Sex
Log-in Credentials
Username* (Letters, numbers, periods, and $ # @ symbols are allowed. No spaces.)
Password * (Letters, numbers, periods, and $ # @ symbols are allowed. No spaces.)