2nd ANNUAL INTERNATIONAL FORUM
“Collaboration: Key to Advancing Healthcare”
August 3 & 4, 2018 • New Jersey, USA
Double Tree by Hilton Hotel Fort Lee-George Washington Bridge
2117 Route 4 East Bound, Fort Lee, New Jersey, USA 07024
Register and Pay By Mail or Online.
If you want to register & send your payment by mail, click here to download the E-brochure and complete the registration form. Make your check or money order payable to UPINHF INC and mail it with the completed registration form to:
UPINHF
c/o Iren Bobis Roldan
26931 Fort Apache Circle
Lake Forest, California 92630
USA
Treasurer’s Contact Information:
Phone# (949) 275-5343
Email Addresses: irenibr3@gmail.com; Treasurer@upinhf.org
If registering and paying online, please complete the online registration form below and make the online payment via PayPal by clicking the PayPal payment button below. You do not need a PayPal account to pay via PayPal. There is an additional $5.00 charge per transaction to pay for the PayPal payment processing fee.
| Selection option and click the PayPal button |
2018 Registration Fees below are for payments made by personal check, cashier’s check, or money order. If paying online via PayPal, please add $5.00 per transaction to cover the Paypal payment processing fee.
| Event | Members & Guests (Fees per Person) Early Bird | Members & Guests (Fees per Person) Postmarked after 7/15 |
| A. Soiree/Welcome - August 3, 2018 Includes Merienda cena Blast to the Past - 60's, 70's, - Renew, Reminisce, Re-energize | $50.00 | $60.00 |
| B. Breakfast Education Program - August 4, 2018 | ||
| With Continental Breakfast | $30.00 | $40.00 |
| Continental Breakfast with 4.8 Contact Hours | $50.00 | $60.00 |
| C. Dinner and Dance | $100.00 | $110.00 |
| Other FEES (If Applicable) | ||
| Annual Membership Fee | $50.00 | |
| Life and Associate Membership (up to 8/4/18) | $100.00 | |
| After 8/4/18 | $150.00 | |
| 2018 Souvenir Yearbook Ad - Camera Ready | Submission Deadline: July 10, 2018 | |
| Full Page | $100.00 | |
| Half Page | $50.00 | |
| Quarter Page | $25.00 |
Online Registration Form
To register for the UPINHF 2018 Forum, please provide the information requested and submit this form.