Spring Conference Educational Attendee Registration I am registering to attend:(Required) April 30 session ONLY – OSHA Topics/Lock Out Tag Out/ARC Flash – Member/Non-member rate – $75 May 1 session ONLY – General Conference Sessions – Member rate – $125 May 1 session ONLY – General Conference Sessions – Non-member rate – $175 (includes a year of voting membership in PSHFE if eligible) BOTH April 30 & May 1 sessions – Member rate – $200 BOTH April 30 & May 1 sessions – Non-member rate (includes a year of voting membership in PSHFE if eligible) – $250 May 1 session – Complimentary (available to those who have been in healthcare facilities mgmt. less than 5 years and have never attended a PSHFE conference) – $0 Your name(Required) First Last Title(Required)Email address(Required) Phone(Required)Employer name(Required) Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you planning on attending the reception on Thursday evening – April 30?(Required) Yes No Special Dietary NeedsMailing A Check I would like to mail a check I am registering only – someone else in my organization will pay via credit card at a later time I qualify for the complimentary registration Total Credit Card(Required)Card Details Cardholder Name
