User Conference & Workshop Sign Up

Name*

Company*

Address*

City*

State*

ZIP Code*

Email*

Nature of Business (check all that apply)*
In-Home Care ServicesIn-Facility ServicesSenior CenterNutrition ServicesOther

If you selected Other, please describe the nature of your business.


Attendees

Attendee 1

First Name

Last Name

Title/Job Function

Attendee 2

First Name

Last Name

Title/Job Function

Attendee 3

First Name

Last Name

Title/Job Function

Attendee 4

First Name

Last Name

Title/Job Function

Attendee 5

First Name

Last Name

Title/Job Function

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Special Requests
Please contact Accessible Solutions at 800-886-2818 for any special needs accommodations or dietary requests.

REGISTRATION: $369 (by 10/31/17. Rate is $399 starting 11/1/2017).

Conference registration includes:

  • Welcome Reception
  • Attendance in all workshops and guest speaker presentations
  • Breakfast every morning
  • Lunch January 24 and 25, 2018
  • Snacks throughout the conference
  • Dinner and social event

Hotel reservations are not included in the conference fee. Please make reservations with the Courtyard by Marriott here.

 

*Required Field

**This registration confirms your interest in attending. We will contact you for credit card payment to finalize registration.