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"PSRC Conference in the Capital" Friday, October 10, 2008 4 Points Sheraton Hotel, Harrisburg, PA "Early Bird" Pre-Registration - By Mail Pre-registration by mail with payment by check or money order must be postmarked by 7/31/08. To register by mail, print out this form, complete it and mail it along with a check payable to the "PSRC Conference In The Capital" to: PSRC Conference In The Capital c/o 809 Pajabon Drive Palmyra, PA 17078-3011 Name_________________________________ Credentials ____________________ AARC Membership #_____________________ (if non-member, write NON-Member) (if you don't know your number, send an email to officeman@psrc.net) Address___________________________________________________________ City _______________________________ State___________ Zip_____________ Telephone (Day) ___________________ E-mail ____________________________ Hospital/Business/School Affiliation_______________________________________ Questions? Send an email to officeman@psrc.net |
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