2025 Administrative Professionals Conference Registration Form

2025 Administrative Professionals Conference Registration Form
Instructions:
- Please complete all requested information.
- Payment must accompany each registration.
- Registrations will be submitted electronically using jotform.
- All registrations must be received no later than Friday, April 4th.
- Attendees should receive an email confirmation from jotform after submitting their registration. If confirmation is not received, please contact your institution's representative (see list below).
- Due to limited seating capacity, we cannot accept payments at the door.
- For questions, please contact your institution's representative or Joanna Huskey.
Conference Cost: $179 (by Friday, April 4th)

Refund Policy:
- Cancellation requests prior to Friday, April 4th will result in a $50 administrative fee.
- No refunds will be granted for cancellation requests on or after Friday, April 4th.
- If you are unable to attend, you may send a substitute. However, no subs will be allowed after Monday, April 7th.
- Notification to Joanna Huskey at jhuskey@wakehealth.edu of substitute must be made by Monday, April 7th.
COVID:
- For COVID information, please visit our website at https://adminprofconf.com/Registration/
Questions: Contact your representative:

FT Lia lmartinez@forsythtech.edu (336) 734-7789

NH Traci trbutler@novanthealth.org (336) 758-6639

WFU Cecile shidlec@wfu.edu (336) 758-5233

Atrium WFB Joanna jhuskey@wakehealth.edu (336) 716-4694

WSSU Joanna jhuskey@wakehealth.edu (336) 716-4694

Others Joanna jhuskey@wakehealth.edu (336) 716-4694

For more details on registration for your organization, please visit: https://adminprofconf.com/Registration/

Attendee & Institution Information
Name*

First NameLast Name
Job Title*
Current job title
Institution*
If institution is other, type name here:
Department Name:*
Address*

Street Address

Street Address Line 2

CityState / Province

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

Method of Payment

For more details on the registration process for your organization, please visit our website at: https://adminprofconf.com/Registration/
Credit Card or Check?*
Wake Forest Reynolda Campus Payment Information (if paying by another method, enter na on each line)*
Atrium Health Wake Forest Baptist Chart of Account (if paying by another method, enter na on each line). Please provide your full chart of account information.*

Parking
Do you need handicap parking?*

YesNo
If yes, what is your handicap parking placard number?

Dietary Needs

Please note: we have options for special diets on our website. We are asking about desserts here so we can get a count of how many gluten free desserts to order.
Do you want a gluten free dessert?*

YesNo

Signature of Approval
Attendee*

First NameLast Name
Date*

MonthDayYear
Supervisor*

First NameLast Name
Date*

MonthDayYear
Should be Empty:

2025 Administrative Professionals Conference Registration Form

Attendee & Institution Information

Method of Payment

Parking

Dietary Needs

Signature of Approval