| Name (Last,First,MI) | |
| Title | |
| Employer | |
| Employers Address | |
| City, State, Zip | |
| Phone |
-
-
Fax
-
-
Cell
-
-
|
| Mailing Address (if different from work) | |
| City, State, Zip | |
| eMail | |
| Mail To | |
| Credit Card | Cardholder: Amount to charge: |
|
|
| Names and titles of additional registrants. |
|
| Registration Fees will increase by $25 after 10/1/08 |
| CSHE Member | $95 (Fee includes: materials, breakfast, and lunch) |
| CSHE Member | $145 (Fee includes: materials, breakfast, and lunch) |
| Non-Member* | $130 (Fee includes: materials, breakfast, and lunch) |
| Non-Member* | $150 (Fee includes: materials, breakfast, and lunch) |
| *(Facility registrants will receive membership in CSHE) |
| |
| Lunch Only (guest ticket) | $30 |
| Golf | $20 |
| Renew Membership Dues - Facility | $50 |
| Renew Membership Dues - Affiliate | $150 |
| MECH Study Guide - Member | $51 |
| MECH Study Guide - Non-Member | $58 |
MECH Certification - Member | $95 |
| MECH Certification - Non-Member | $145 |
