2012 PACAH Spring Conference
April 23-26, 2012

 

Full Conference Fee: $290

Attendee Information
First Name:  
Last Name:  
Name for Badge (optional):
Title:  
Company:  
Address:  
City:  
State:  
Zip:  
Email:  
Phone:  
Days Attending:
(check all that apply)
Other Events:
- Monday Education Session (1:00 - 4:00)
Guest Information
(includes group meals, activities, & PACAH sponsored events) NHA credits do not apply. Guests can not include staff from facilities.

Guests ($70 Each) Fill out each field and press the + button to add the guest to your registration
First Name: Last Name:

 

Miscellaneous
Please list any special dietary or physical accommodations or needs as described by The Americans with Disabilities Act (ADA).

 

Payment and Cancellation Information
Cancellations must be submitted via email to Stephanie Auker and must be received by 4 pm on April 9, 2012 to qualify for a refund. NOTE: No requests for refunds of the registration fee will be honored after that date. However, if last minute schedule changes prevent you from attending the meeting, another may attend in your place. A $25 administrative fee will be deducted from all refunds issued. ALL REGISTERED NO SHOWS WILL BE BILLED.



If you experience issues with online checkout, please contact Stephanie Auker at (717) 232-7554 x 3134

Total Due: $290.00