2023 WSSHE Spring Symposium Attendee Registration

Attendee Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• Industry Certification:

• Fee

  Type	Fee
  Professional Member	$250.00
  Professional Non Member	$275.00
  Business Partner Member	$350.00
  Non Member Business Partner	$425.00
  Thursday Night Dinner (Non-Attendees Only)	$75.00

Business Information

• * Company:
• * Job Title:
• * Address 1:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Phone:

Please answer the following questions:

• *

  Are you a WSSHE Member?

  • Yes
  • No
• *

  Are you an ASHE Member?

  • Yes
  • No
• *

  Are you a new member of WSSHE in 2022 or first time attending a WSSHE Annual Conference?

  • No
  • Yes, new 2023 member but not first time attending
  • Yes, first time attending but not a member
  • Yes, new 2023 member and first time attending
• *

  Are you planning on attending the Thursday night dinner?

  • Yes
  • No

Additional Attendees Information

You may add a maximum of 20