A

H

F S A        

  

      HEALTH    

Association of Health Facility Survey Agencies

     "Monitoring the health care of a nation"

        


 

Annual Conference Registration
San Antonio, Texas
October 5-7, 2009

Meeting Fees: $550 each for the first two state agency registrants and $300 for each additional state agency registrant.
  No partial registration fee will be accepted.

$600 for each private sector registrant. 

Additional meals may be purchased for each guest not attending the meeting for a cost of:
Sunday reception $25 - Monday lunch $25 - Tuesday Awards luncheon $35.    

1st Representative Name   
2nd Representative Name 
Additional Attendee              
Additional Attendee              
Additional Attendee              
Additional Attendee              



Organization 
 
Address 
Phone Number    E-Mail Address 
                                                                         
      (For Billing)

Method of payment: Check in process  Invoice requested

Total amount 

Please make checks payable to AHFSA and mail to:
            AHFSA
            5105 Solemn Grove Rd.
            Garner, NC 27529


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