PREP/APRA - Conference Registration

email address: Leave this field email-address blank:
Homepage: Leave this field homepage blank:
URL: Leave this field url blank:
Comment: Leave this field comment blank:

Conference Registration

November 2 & 3, 2011

Registration Deadline October 24, 2011

Please complete one registration form per person for all registrants from your organization.
If you would like to become a member prior to registering for the conference, please visit the Member Services page and join, then return to register for the Conference.

First Name*

Last Name*

Organization*

Title*

Address 1

Address 2

City*

State*

Zip*

Work Phone*

Home or Cell Phone

Email*

This is my first PREP/APRA conference

Registration Options*

$65 - Paid PREP/APRA MEMBER Registration
$80 - Paid PREP/APRA MEMBER Registration + Dinner Social
$125 - NON-MEMBER Registration
$155 - NON-MEMBER Registration + Dinner Social

Form of Payment*

Pay via Paypal
Pay via Check: John Luvisi, Alvernia Univ., 540 Upland Ave., Reading, PA 19611

Verification:

7 add 6

Fill in the result

Notes

A continental breakfast, lunch, and snacks are included in the conference fee. A vegetarian lunch option will be available.
Dress is Business Casual
PREP/APRA has no control over the temperature of the conference room.
PREP/APRA intends to provide professional contact information (work address and phone number) for conference attendees to our presenters.

Website Design by: NABWD