To Register:

Please submit this form online, (use a separate form for each registrant)

Payment of Fees:
Checks should be made payable to IntraNexus Healthcare Users' Group; Credit Cards accepted (call Joe for info).

Mail Payment To:
Joseph Ruark
Assist VP of Patient Finance, St. Elizabeth Hospital
401 E. 2nd St.
Covington, KY 41014

If you have any questions please contact Joe at 859-292-4245 or jruark@stelizabeth.com

If you will be attending with a guest, list your guest's name in the space provided below, Guest Fee is $150.

Conference Fees:
$395 if you register by October 1, after October 1, fee is $445
Discount for 2 attendees from the same organization, $375; 3 attendees (or more) from the same organization, $350 each if registered by October 1.

AFTER October 1, Discount for 2 attendees from the same organization, $425 each; 3 attendees (or more) from the same organization, $400 each.

Room Reservations:
Conference Room Rate, if room is guaranteed by September 10, 2008, $124 plus tazes and fees.
Cancellation requires 14 days notice.
Use the IHUG HOTEL link from the IntraNexus Client Portal, or contact the Hilton at 757-213-3001

Registrant Information:

Name:
Name for badge:
Title for Badge:
Organization:
Address:
City:
State:
Zip:
Phone:
Fax:
E-Mail address:
Guest:
Name for Badge:

Please fill in and total

Registration fee before 10-01-2008
$395 for 1; or $375 each for 2; $350 each for 3 or more

Registration fee after 10-01-2008
$445 for 1; or $425 each for 2; $400 each for 3 or more
Guest Fee ($150.00)
TOTAL FEES $
 
 
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