TriState SHRM Conference 2010: Online Registration Form

STEP 1: Complete and SUBMIT the registration form below.
STEP 2: You will receive a recap of your registration information to REVIEW and CONFIRM.
STEP 3: You will be taken to SECURE PayPal site for credit card processing or have the option to pay by check.
IMPORTANT: If you leave this form before submitting it, you will lose any information you have entered.

First Name:
Last Name:
SHRM National Member? Yes No

Certifications:
Primary Chapter:
SHRM Nat'l ID:

Title:
Industry:
Company:
Address1:**
Address2:
City:
State:	Zip Code:
**If your address consists of only one line, please enter it in the Address1 field

Chief HR Officer?	Yes No
# Employees:

Phone:	Ext:
Fax:
E-Mail:

***School name must be provided if you are choosing Student Registration

Student Chapter Member? Yes No

School***:

Pre-Conference WorkshoP Separate fee of $50 -- includes breakfast
Apr 8	-- Pre-Conference:
Conference Sessions - Thursday
Apr 8	-- Thurs PM #1:
Conference Sessions - Friday
Apr 9	-- Friday AM #1:
Apr 9	-- Friday AM #2:
Apr 9	-- Friday PM #1:
Apr 9	-- Friday PM #2:

Check here if you are registering for Legislative Pre-Conference/Breakfast - $50 This cost will be $0 if you are registering for the $100 Legislative Pre-Conference Only

CHoOSE TYPE OF CONFERENCE REGISTRATION & PAYMENT


$450		Regular Registration: Non-SHRM National Member

$400		Regular Registration: SHRM National Member

$100		Legislative Pre-Conference Only

$250		One Day Conference Registration : Thursday Only (Does not include the Dinner Event at the U.S. Naval War College)

$250		One Day Conference Registration: Friday Only (Does not include the Dinner Event at the U.S. Naval War College)

$150		Student Chapter Member Registration: Full Conference (Does not include the Dinner Event at the U.S. Naval War College)

$75		Student Chapter Member Registration: One Day : Thursday (Does not include the Dinner Event at the U.S. Naval War College)

$75		Student Chapter Member Registration: One Day: Friday (Does not include the Dinner Event at the U.S. Naval War College)

MEALS AND SOCIAL EVENTS FOR ATTENDEE ARE INCLUDED IN COST OF FULL-CONFERENCE REGISTRATION
Weds Evening, April 7 - Networking Reception	Plan to attend?	Yes No
Thurs Afternoon, April 8- Relaxation Reception	Plan to attend?	Yes No
Thurs Evening, April 8- Evening and Dinner Event: U.S. Naval War College (transportation Included)	Plan to attend?	Yes No

TICKETS TO EVENING & DINNER EVENT AT THE U.S. NAVAL WAR COLLEGE $100/EACH FOR ONE DAY REGISTRANTS AND FOR NON-REGISTRANTS (GUESTS)
Enter Number of Tickets Needed at $100 each:

I have read, and agree to accept, the Conference's Cancellation Policy.

ADA Accomodations
If you need special arrangements to fully participate in this conference, please contact us.

After you submit this form, you will receive a recap to review.
You can then return to this form if you need to make any changes.
This may take a few moments, so please be patient.

Do NOT click Submit more than ONCE.

Site maintained by Such Consulting