Alabama Society of Hearing Healthcare Providers & Georgia Society of Hearing Professionals 2022 Summer Meeting Registration Form
Please register one attendee at a time. If you have multiple people to register, refresh the form after submission to complete for each person. All Society Memberships will be verified and if not current, you will be billed/charged the difference at registration.
Name
*
First Name
Last Name
Designation(s) (ex., ACA, AuD, BC-HIS)
Your Name as it Should Appear on Badge
*
E-mail
*
Business Name
*
Business Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number (Daytime)
*
-
Area Code
Phone Number
How did you hear about the conference?
Do you have special dietary needs? If so, what are they?
Interested in also becoming a member of ASHHP or GSOHP? Complete the membership form at:
ASHHP:
https://ashhp.com/ashhp-membership/ashhp-membership-application
GSOHP:
https://gsohp.org/gsohp-membership/JOIN
Please Select a Registration Level
*
prev
next
( X )
Alabama/Georgia/Florida Society Members
$
300.00
Includes all CEUs and social activities.
NON Chapter Members
$
450.00
Includes all CEUs and social activities
Additional Social Package
$
100.00
Includes breakfast Saturday & Sunday and Lunch Saturday
Manufacturer Exhibitor
$
500.00
Includes table, and social events
Total
$
0.00
Submit Registration
Should be Empty: