HCC Registration - Wisconsin Healthcare Engineering Association

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HCC Registration Fee

$275

Please fill out your Organization Information before adding attendees. You can add up to 10 attendees on this form.

WHEA Chapter*

If you have paid dues to a WHEA Chapter, please choose which one. If you don't know, just choose "Not a WHEA Member".

Organization*

Contact Email*

Work Phone*

Address*

Street Address City State Zip

Payment Option*

Please provide P.O. Number:*

Comments

Indicate special needs that you might want us to know about. ( i.e handicap access, Food Allergies, etc)

Gift Certificate #:

Add your Attendees

You can add up to 10 attendees on this form.

Attendees

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There are no Attendees.

Please fill out your organization info before adding attendees.

Registration*

Price: $200.00

Total

If payment is to be made by Check or P.O. number, return a copy of your invoice page with check payable to WHEA and mail to:

Wisconsin Healthcare Engineering Association
PO Box 2254
Oshkosh WI 54903

info@whea.com

Credit Card

American Express

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Card Number

Expiration Date

Security Code Cardholder Name

All registration fees must be paid in advance. A fee of $50 will be charged to any cancellation made 2 weeks before the program date. There will be no refunds after the program virtual binder pdf file link has been sent to attendees. If the program is cancelled for any reason, refund is limited to the program fee.