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Home > Activities > Annual Symposium > Registration
2012 Symposium Registration
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To register for the 2012 NERHRT Symposium, please complete one of the forms listed below.

For more information, please contact Marion Pawlek at 603-643-2800 or .
Registration Form 01 (Complete this form to pay offline by mail)
* Required
Full Name *
Title & Credentials *
Organization *
Mailing Address *
City *
State *
Zip *
Phone *
Email *
Individual Registrant (please select one)
Full conference (October 25-26, 2012)
Student Rate: $50.00
Member Rate: $120.00
Non-Member Rate: $145.00
Thursday only (October 25, 2012)
Student Rate: $25.00
Member Rate: $50.00
Non-Member Rate: $60.00
Friday only (October 26, 2012)
Student Rate: $50.00
Member Rate: $120.00
Non-Member Rate: $145.00
Questions/Comments (Please list any dietary restrictions)
To pay offline (by mail)
Registration Form 02 (Complete this form to pay online with credit card)
* Required
Full Name *
Title & Credentials *
Organization *
Mailing Address *
City *
State *
Zip *
Phone *
Email *
Individual Registrant (please select one)
Full conference (October 25-26, 2012)
Student Rate: $50.00
Member Rate: $120.00
Non-Member Rate: $145.00
Thursday only (October 25, 2012)
Student Rate: $25.00
Member Rate: $50.00
Non-Member Rate: $60.00
Friday only (October 26, 2012)
Student Rate: $50.00
Member Rate: $120.00
Non-Member Rate: $145.00
Questions/Comments (Please list any dietary restrictions)
To pay online (credit card)
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10 Benning Street, Box 184, West Lebanon, NH 03784, 603-643-2800
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