Registration

2012 Spring Conference Fees

VaSHHRA Member: $99

Additional Member: $89

(from same facility)

Non-VaSHHRA Member: $130

Includes a 2012 One-Year Regular Membership

Non-member Guest: $100

(attending with a member)

Guest (meals only): $75

Two Ways to Register...

Option #1: Print out and fill in our PDF registration form and mail it in along with a check.

Option #2: Fill in our Online Registration form below. (You can then opt to pay online via credit card or at the conference via check.)

Online Registration

Attendee Information

First Name*
Last Name*
Title*
Organization*
Address
City
State
Zip
Phone*
Fax
Email*
Please indicate the functions in which you plan to participate.
Thurs. Breakfast (# attending)
Thurs. Luncheon (# attending)
Thurs. Reception (# attending)
Friday Breakfast (# attending)
Friday Boxed Lunch (# attending)
Attendee Names
Please enter the names of all those from your organization attending the conference
Guest Names
Please enter the names of those in your party not attending the conference (i.e., meals only)
Special Dietary Requirements for Attendees and Guests