GHSHRM Education Day 2019
Friday, March 01, 2019
8:30 AM - 4:30 PM
Location: The Houstonian Hotel, Club & Spa
Directions: 111 North Post Oak Lane, Houston, TX 77024

REGISTRANT * required
First Name *

Last Name *

Designation (e.g., RN, JD, ARM)

Title

Company/Firm/Organization

CONTACT INFORMATION
Phone Work (include area code) *

Cell Phone (include area code)

E-mail *

 

ADDRESS
Address *

Address 2

City *

State *
   Zip *

Will you be attending the Welcome Reception *
on Thursday February 28, 2019 from 6:00pm - 8:00pm
Yes  No

To reserve a room at the Houstonian call 713/685-6810 
(single $229; double $249). Please reserve by 2/15/2019

Please indicate below which type(s) CEU apply to you: *
Nursing Legal Insurance CPHRM 
N/A

PAYMENT INFORMATION  *
Early Bird (before February 1, 2019)

Member - $180
Non-Member - $255
Student - $130

TOTAL AMOUNT

Method of Payment:
 Pay at the Door    Credit Card

Credit Card Information (all fields required)
Card Type

Cardholder's First Name

Cardholder's Last Name

Credit Card Number

Exp Date
(e.g.: 05/2020)
Security Code

 

Cardholder's Billing Street Address

Billing City

Billing State
(2-digit state code)
Billing Zip Code

Billing Country
(2-digit country code)