2012 HIRA Annual Conference

Member Registration Fee: $595.00
Spouse/Significant Other: $200.00
Guest: $700.00

July 18-20, 2012
The Allerton Hotel
Chicago, IL

Program Schedule – 2012 HIRA Annual Conference

HOTEL RESERVATIONS
Call for hotel reservations: 312-440-1500 or 877-701-8111
Be sure to mention Health Industry Representative Association (HIRA)
Group rate is $135.00 plus taxes.
This rate also applies to 3 days prior to and 3 days after the conference – based upon availability
Deadline for reservations is June 26, 2012

Membership Type Rep Member
Allied Member
Service Provider Member

Name - as you would like it on your name badge *

Name of Spouse / Significant Other if they are attending

Title

Company *

Street Address

City

State

Zip

Phone Number *

Email Address *

I plan to attend the Allied Session "Working with Reps" 8AM on 7/18/12 Yes No *

I plan to attend the Cubs game 7/18/12. Yes No *

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Please use the PayPal button below to complete your registration.

Select if you will be attending by yourself or with your Spouse or Significant Other. The selections are:

• Member Only $595
• Member and Spouse $795
• Guest $700

Please make your selection below and then click on the "Pay Now" button to complete your transaction.