Conference Registration Form

Conference Registration Form

May 24-27, 2024 - Hyatt Regency Denver Convention Center - Denver, CO
Early-bird registration rates are available to 11:59 pm CT on April 15th. As of April 16th, regular registration rates will apply.
Name*

First NameLast Name
Email*
example@example.com
Cell Phone (in case we need to reach you)*

Country CodeArea CodePhone Number
Title (for name badge, if desired)*
Preferred name to appear on name badge
Pronouns (for name badge, if desired)*
Institution/Affiliation (for name badge)*
Emergency Contact Person and Cell Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
YesNo
YesNo
Friday night reception (Friday, May 24, 2024)Lunch (Saturday, May 25, 2024)Lunch (Sunday, May 26, 2024)Grad Student Social (Sunday, May 26, 2024)Lunch (Monday, May 27, 2024)Reception/Dinner (Monday, May 27, 2024)
Yes, as a MenteeYes, as a MentorNot Interested
No preferenceGluten FreeGluten Free/Dairy FreeVegetarianVeganOther
SalmonBeefDietary restriction option
Yes (Be sure to check the "Guest" box on ticket pricing below)No
Guests are eligible to attend the Friday night reception/opening session and the closing night reception/banquet. Guests are not eligible to attend any other food/beverage functions or presentation sessions. If you would like your guest to attend meals and sessions, they must register as an attendee.
For your each of your guests, please tell us their names and pronouns.*
Reception/Opening Session on Friday Night (Friday, May 24, 2024)Closing Reception/Dinner on Monday night (Monday, May 27, 2024)
No preferenceGluten FreeGluten Free/Dairy FreeVegetarianVeganOther
SalmonBeefDietary restriction option
Yes, I would like a printed programNo, an electronic version is fine.
Tell us anything else that we need to know about you or your guest in order to provide an excellent experience at NASSH. Email Kim Scott, conference manager with any questions (kimscott.nassh@gmail.com)

Registration Fees: Ticket pricing includes 5% cancellation insurance.*

Remote Registrant

$105.00

Student

$288.75

Under-Employed

$288.75

Retired

$367.50

Regular Attendee

$498.75

Guest

$100.00 Quantity

Donation to NASSH (choose quantity in increments of $25)

$25.00 Quantity

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Conference Registration Form

Early-bird registration rates are available to 11:59 pm CT on April 15th. As of April 16th, regular registration rates will apply.