Conference Registration

Step Forward Together:
The 2008 Public Health Partners Conference

July 22-24, 2008

Monona Terrace Community and Convention Center

Madison, Wisconsin

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Conference Home

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Conference Content & Registration

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Travel and Lodging

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Exhibit, Sponsor, Advertiser Information

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About Madison

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WPHA Home

On-line Conference Registration

Pre-Conference Activities - July 22, 2008

Conference - July 23-24, 2008

Monona Terrace Community and Convention Center

Madison, WI

Please fill out the following fields to complete your registration. Privacy Statement

Name:

Agency/Employer:

Address:

City:

State:

Zip Code:

00000-0000

Phone:

000-000-0000

E-mail Address:

Information provided for:

Home Work

Check here if you are requesting a vegetarian lunch or have another dietary restriction.

If Other, please explain:

Check here if you have special needs (i.e. physical, dietary, etc.) WPHA will contact you.

REGISTRATION FEES

Membership Level	Conference & Pre-Conference	One Day Pass (July 23 or 24)	Pre-Conference Only
Member Includes WPHA, WALHDAB, and NALBOH members.	$195.00	$125.00	$75.00
Non-Member	$270.00	$200.00	$75.00
Student Member / Retired Member	$80.00	$60.00	$25.00

Registration Type:

Member Type:

For Non-Members:

Would you like to apply $75.00 of your registration towards a 2008 WPHA Membership?
Yes No

BREAKOUT SESSIONS

Please list your preferred session(s). Session information is available here. This information will be used to assign rooms. Attendees are not required to attend based on their selections, nor will attendees be guaranteed space based on the information provided.

Date	Time	Choose Session
July 22	9:00a
	1-5:00p
	1-4:00p

July 23	10:30a
	2:15p

July 24	9:45a
	11:00a
	2:00p