NYDHA Empire Virtual Conference/Annual Session Registration Form

October 23-24, 2021

Name:*
Address:*
Phone:*
-
E-mail:*
Is this your first conference?
Registration type:*

Not yet a member? Use the member rate if you join now.

Event Registration: Conference registration entitles your entry into the virtual continuing education courses and exhibitors’ hall, as well as access to the NYDHA Whova app. This app will give attendees the ability to interact and obtain resource information. There will be opportunity for attendee and exhibitor engagement between courses. Info on use of the Whova app will be provided to registrants.


After registration and payment, you will receive access information.Please check the box below for courses that you plan to attend. There will be no concurrent CEs this year—all will be plenary.

Courses:
Total Registration Fees (please use numbers only, no periods):*
 $ 

Cancellation Policy:Written notice of cancellation accepted if postmarked or emailed by October 10, 2021. Written cancellations received October 11-15 subject to a $20.00 processing fee. Sorry, cancellations received after October 15 cannot be honored.

NOTE: When you click on Submit, you will be taken to PayPal to complete your payment securely. You can use your PayPal account, or use your credit or debit card if you don't have a PayPal account. When you are finished with your payment, you will receive a confirmation email.