Event Registration
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Winter Institute 2011

Jan 19, 2011 - Jan 21, 2011
Ritz Carlton Lodge, Reynolds Plantation, Lake Oconee, GA

REGISTRATION DEADLINE:  Jan 12, 2011

Personal Information:     All inputs are mandatory EXCEPT the Membership #.

First Name:
Last Name:
Title:
Badge Name:
Organization:
HFMA Mbrshp #:
Work Phone:


Mailing Address:

Address:
City:

  State:    Zip: 
E-Mail:


Membership Information:

GHFMA Corporate Sponsor:    
HFMA Membership Status:      
Additional Membership Info:
Teams Faculty GAMA Member
Board Chapter Photographer GAHE Member
Officer Exhibitor ++ CPAR
Lifetime Member GA Past-President CPA
Chairperson of Education Content / Logistics / Registration committee.

++ Exhibitors please refer to and coordinate with the vendor exhibition material.


Additional Information:

Please enter the number and names of children and/or guests that may be joining you at this event. These guests will not be permitted to attend sessions.

Number Of Children
Please enter their names:
Number of Guests
Please enter their names:
 




General Fee Information:

We accept checks by mail, pay on-site, or online credit card transactions.

EARLY BIRD
(through 12/17/2010)
Member($215.00)
Non-Member($290.00)
REGULAR
(12/18/2010 - 1/12/2011)
Member($245.00)
Non-Member($320.00)
ON-SITE REGISTRATION
If your registration is not received
by 1/12/2011 you must pay on-site fees.
Member$290.00
Non-Member$345.00