The PSRC & Wellspan Health Present:  
                                       "2010 Sleep Seminar"

                                       Wednesday, April 28, 2010
                         Wellspan Human Resource Center - Room 148
                              1135 South Edgar Street - York, PA 17403
______________________________________________________________________

                                Pre-Registration - By Mail

To register by mail, print out this form (or click here to download and print a PDF file of the conference program which includes this form), complete it and mail it along with a check payable to the "PSRC" to:

PSRC Sleep Seminar
c/o 225 Hampshire Drive
Sellersville, PA 18960-2876

Registration Rate                AARC Discounted Member Rate            
........$50.00................................................$30.00                                                  
                                                 (must provide valid AARC membership #)

Pre-registration by mail with payment by check or money order must be postmarked by 4/19/10


Name_________________________________      Credentials ________________

AARC Membership #_____________________ or    ___  Non-AARC Member
(If you don't know your membership number, call the AARC at 972-243-2272)

Address___________________________________________________________

City _______________________________ State___________ Zip_____________

Telephone (Day) ___________________ E-mail ____________________________

Hospital/Business/School Affiliation_______________________________________

Full refund provided for cancellations made by April 1, 2010. A credit for a future PSRC event will be provided for cancellations made after April 21, 2010.

Questions? Send an email to ExecutiveDirector@psrc.net