2014 HR Conference WVSHRM/WVHHRA

Full Name:                                                                   (First name for badge)                      

Company/Organization:                                                                                                         

Preferred Mailing Address:                                                                                                    

City:                                                 State/Province:                     Zip/Postal Code:         

Country:                                          Telephone:                                            Fax:                   

Email:                                                                                                                                         

CONFERENCE FEES

1. Registration Fees (All fees listed in U.S. Funds.)   Includes reception, 1 lunch, breaks, banquet, and proceedings.

Please check appropriate registraion fee:             

     WVSHRM or WVHHRA Member                               r   $50               

     Nonmember                                                               r   $100             

     Student                                                                      r   $50               

                                                                                                      $ ____________

                                                                                              total enclosed:         $ __________

Count me for lunch (Thursday):        r                                     Vegetarian meal required:                                      r  

Count me for banquet (Thursday):    r                                     Vegetarian meal required:                                      r  

Please list any ADA Special Needs:                                                                             

PAYMENT METHOD  Check or Money Order must be in U.S. funds payable to: WVSHRM.  There will be a $25.00 fee charged on checks returned by the bank due to insufficient funds. Registration confirmation/receipt and further information will be mailed.

Please check appropriate box:   r Check    r Money Order  

Please mail completed registration form with payment to:  

            2014 WVSHRM/WVHHRA Conference

Phone:    (304) 933-8156                                                                              Carolyn Wade

FAX:        (304) 933-8183                                                                              Steptoe & Johnson

Email:     carolyn.wade@steptoe-johnson.com                                        400 White Oaks Blvd.

                                                                                                                       Bridgeport, WV  26330