Home
Terms of Service
Privacy Policy
Conferences
Past Conferences
CEU Program
Criteria for Awarding CEU
Contact
About
Board
>
Board Only
Past Presidents
Store/Registrations
Members-Only
Michelle's Test Page
Home
Terms of Service
Privacy Policy
Conferences
Past Conferences
CEU Program
Criteria for Awarding CEU
Contact
About
Board
>
Board Only
Past Presidents
Store/Registrations
Members-Only
Michelle's Test Page
2017 WISHET Fall Conference Registration Form
October 26-27, 2017
Oshkosh, Wisconsin
Contact Information:
*
Indicates required field
Hospital/Organization
*
Contact Name
*
First
Last
Business Address
*
Business Address 2
*
City
*
State
*
Zip Code
*
Contact Phone Number
*
Contact Email
*
Attendee 1 Information:
Attendee #1 Name
*
First
Last
Registration Type
*
Current Member Full Conference+2018 Membership - $300
Current Member Day 1+Membership - $220
Current Member Day 2+Membership - $180
Current Member Full Conference Only- $240
Current Member Day 1 Conference Only - $160
Current Member Day 2 Conference Only - $120
Non-member Full Conference+2017-18 Membership - $320
Non-member Day 1+Membership - $230
Non-member Day 2+Membership - $190
Non-member Full Conference Only - $260
Non-member Day 1 Conference Only - $170
Non-member Day 2 Conference Only - $130
2018 Membership Only (no conference) - $60
Hospital/Organization
*
Title
*
Phone Number
*
Email
*
Breakfast and lunch are included. Do you require any special dietary considerations?
*
No
Yes, describe
Dietary Considerations
*
Redeeming a WISHET Passport? Upload here!
*
Max file size: 20MB
Are you a WISHET member redeeming a Passport? At 25 points, submit for a $50 credit toward membership renewal or conference fees.
Attendee 2 Information:
Please complete all fields if you are registering a 2nd attendee.
Attendee #2 Name
*
First
Last
Registration Type
*
Current Member Full Conference+2018 Membership - $300
Current Member Day 1+Membership - $220
Current Member Day 2+Membership - $180
Current Member Full Conference Only - $240
Current Member Day 1 Conference Only - $160
Current Member Day 2 Conference Only - $120
Non-member Full Conference+2017-18 Membership - $320
Non-member Day 1+Membership - $230
Non-member Day 2+Membership - $190
Non-member Full Conference Only - $260
Non-member Day 1 Conference Only - $170
Non-member Day 2 Conference Only - $130
2018 Membership Only (no conference) - $60
Hospital/Organization
*
Title
*
Phone Number
*
Email
*
Breakfast and lunch are included. Do you require any special dietary considerations?
*
No
Yes, describe
Dietary Considerations
*
Redeeming a WISHET Passport? Upload here!
*
Max file size: 20MB
Are you a WISHET member redeeming a Passport? At 25 points, submit for a $50 credit toward membership renewal or conference fees.
Attendee 3 Information:
Please complete all fields if you are registering a 3rd attendee.
If you have more than 3 persons attending from your organization, please submit another registration form.
Attendee #3 Name
*
First
Last
Registration Type
*
Current Member Full Conference+2018 Membership - $300
Current Member Day 1+Membership - $220
Current Member Day 2+Membership - $180
Current Member Full Conference Only - $240
Current Member Day 1 Conference Only - $160
Current Member Day 2 Conference Only - $120
Non-member Full Conference+2017-18 Membership - $320
Non-member Day 1+Membership - $230
Non-member Day 2+Membership - $190
Non-member Full Conference Only - $260
Non-member Day 1 Conference Only - $170
Non-member Day 2 Conference Only - $130
2018 Membership Only (no conference) - $60
Hospital/Organization
*
Title
*
Phone Number
*
Email
*
Breakfast and lunch are included. Do you require any special dietary considerations?
*
No
Yes, describe
Dietary Considerations
*
Redeeming a WISHET Passport? Upload here!
*
Max file size: 20MB
Are you a WISHET member redeeming a Passport? At 25 points, submit for a $50 credit toward membership renewal or conference fees.
Payment Method
Payment Method
*
Pay with Credit Card
Invoice My Facility
Cancellation Policy: Cancellations received at least two weeks prior to the conference will receive a full refund, less a $25 processing fee. No refunds will be given for cancellations received less than two weeks prior to the conference. Substitutions are accepted. Memberships are non-transferrable.
Submit Registration
