REGISTRATION FORM

REGISTRATION FORM

2023 IL NAHRO Conference
Name

First NameLast Name
Title
Organization/Agency
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Conference Registration Fees

IL NAHRO Member Registration Fee … $150Non-Member Registration Fee …………..$200
Late Registration Fee for members (After August 1st)....................……............$175Late Registration Fee for Non-members (After August 1st)…….......................$225
Total amount enclosed (After August 1st, submit late registration fee)
Conference registration is required! Please photocopy registration form as needed and complete a separate form for each conference attendee. Any Questions? Contact Latina Faulkner, IL NAHRO at 217-753-5757 ext. 206 or by email at latinaf@sha1.org.
Please make check payable to IL NAHRO

Mail completed registration form to:

IL NAHRO

Attention: 2023 Conference

200 North 11th Street

Springfield, IL 62703
Vegetarian Meals
Food Allergy
Accessibility Needs
Hotel Information:

President Abraham Lincoln Hotel
To make reservations on-line:

https://www.hilton.com/en/attend-my= event/ilnahroconference2023/

Select "Book a Room"
Should be Empty: