NHAHPERD Conference Registration

NHAHPERD Annual Conference, Waterville Valley
(November 18th to 19th, 2010)

2010 Conference Registration and Membership Form

NAME
First Name: Last Name:
* All Fields Required
 
HOME MAILING ADDRESS
Street: Email:
City: Phone:
State: Preffered Mailing Address
Zip:    
* All Fields Required
 
WORK MAILING ADDRESS
School / Business Name:
Street: Email:
City: Phone:
State: Preffered Mailing Address
Zip:    
* All Fields Required
 
* PLEASE CHECK ONE IN EACH COLUMN
Interest Area Responsibility Employment Level
Health Teacher Pre to Elementary
PE Student Middle
Recreation Retiree Secondary
Dance Administrator College/University
Other Other Agency
 
CONFERENCE PRE-REGISTRATION FEES
*Membership is required for Conference Attendance & is included:
    · $20 Professional
    · $10 Student

*Conference Handout Book Included
 
* SELECT ONLY ONE
Professional Two Days - $105
Professional One Day - $80 (Thursday) (Friday)
Student Two Days - $55
Student One Day - $40 (Thursday) (Friday)
Retiree Two Days - $75
Retiree One Day - $60 (Thursday) (Friday)
 
CONFERENCE EXTRAS
Technology Preconvention Workshop Wed. 11/17 - 6 - 8:30 pm - $10
Thursday night Awards/Banquet Dinner Ticket - $25
          Chicken     Fish     Vegetarian
**Any Dietary Restrictions?
 
($10 increased onsite registration for Professionals/Students if postmarked after 11/3)