Conference Registration

• Conference Fee – $975.00
• Early Bird fee postmarked prior to July 1, 2008 – $875.00
• Special Group Discount: First two conference registrants pay full price, the third person from the same organization may register at no charge (3rd person free)

(Please print or download a pdf copy of this form – complete – FAX or mail to IEHRA)
- Click here to download this form -
Click here to download Form

The Conference fee includes general sessions, welcome reception on Wednesday evening, breakfast and lunch on Thursday and Friday, dinner and event on Thursday evening. The fee is fully refundable if cancellation is received prior to 8/29/08. (Spouses are invited to attend the Welcome Reception, the Thurs. Eve. Dinner Event and the Fri. Luncheon at no cost )

Name______________________________________Title______________________________________________

Name for Badge_______________________________________________________________________________

Company_____________________________________________________________________________________

Address______________________________________________________________________________________

City_________________________________________________________State____________Zip_____________

Phone #_____________________ Fax #_________________ Email_____________________________________

Spouse will attend ____Yes ___ No Spouse’s name for badge __________________________________________

Please select the payment option you wish to use.

[ ] CHECK My check for $___________ made payable to IEHRA
*Mail check and completed form to: IEHRA, 3514 Sycamore Shadows, Kingwood, TX 77339

[ ] CREDIT CARD Please charge $_____________to my: [ ] American Express [ ] VISA [ ] Master Card
*If paying by credit card FAX this completed form to IEHRA - 281-358-9367 (No cover sheet necessary)

Card No:______________________________________________________ Exp. Date______________________

Name as it appears on credit card (please print)______________________________________________________

Signature _____________________________________________________Date signed______________________

Hotel Accommodations: Reservations may be made by calling the Peabody Hotel at 800-732-2639 or 901-529-4000. A block of rooms have been reserved for conference participants at the discounted rate of $180.00 per night during the conference plus a daily service fee and taxes. Please mention that you are with the IEHRA Conference and make your reservation by September 1, 2008 to ensure this rate.

Conference cancellation policy: If cancellation is received by Friday, August 29, 2008, a full refund will be granted. If cancellation is received between August 30th thru, September 15th one-half the registration fee will be refunded. There will be no refund for cancellations after September 15, 2008 or for no shows. Cancelled registrations may not be carried forward to future conferences. Substitutions for paid registrants may be made at any time.

Dress: Business Casual. Note: A/C will be carefully controlled. However, individual comfort levels vary; a sport jacket or sweater is recommended.

Special Needs: In you have any special dietary or other requirements, please advise Paul Floth in advance (IEHRA TEL. # 281-358-4063)

For additional information about the conference or registration contact:
Paul Floth, Executive Director, IEHRA at
281-358-4063 or e-mail pefloth@iphra.com