TORCH 2012 Registration Form

2012 TORCH ANNUAL CONFERENCE
& TRADE SHOW
ONLINE REGISTRATION (HOSPITALS ONLY)

Hospital Information
Vendors may participate at a sponsorship level only. If you are a vendor, please contact the TORCH office at (512) 873-0045 for more information.

Instructions
1. Please fill out the form below and click "Click Next" button. This will direct you to our payment registration page. Alternatively you can download the Registration Form by clicking (HERE)

For Best Use, use Internet Explorer.

Full Conference Registration Fees:

TORCH MEMBER FEES

      First registrant: $225
      Second registrant: $200
      Each additional registrant: $180
      Students: $50

► NON-MEMBER FEES

Each registrant: $325

Students: $100

► AFTER MARCH 28th, 2011
(ONSITE/LATE REGISTRATION FEE)

TORCH MEMBER: $265
NON MEMBER: $350

Single-Day Registration Fees:

TORCH MEMBER FEES

       Wednesday: $80
       Wednesday & Thursday: $170
      Thursday: $130
       Friday: $80

►   NON-MEMBER FEES
       Wednesday: $100
       Wednesday & Thursday: $185
       Thursday: $150
       Friday: $100

►   DAY PASSES DO NOT INCLUDE EVENT FEES

►   SPOUSE/GUEST EVENT FEES
       Wednesday Reception: $30
       Thursday Luncheon: $30
       Thursday Reception: $30

Download 2012 TORCH Annual At A Glance

Download 2012 TORCH Program Description

Registrant Main Contact Info
Hospital Name:
First Name:
Last Name:
Title:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
1
Alternative Contact
First Name:
Last Name:
Phone Number:
Email Address:

# of registrants (TORCH MEMBER)
# of registrants (NON MEMBER)
Total Registration Fee ($):

QUESTIONS? Call the TORCH Office at (512) 873-0045 or email us at torch@torchnet.org


Click here to download Registration Form

Additional Attendees:

IMPORTANT: IF ADDITIONAL ATTENDEES PLEASE COMPLETE THE INFORMATION BELOW ! ! !

Conference registration fee is per person and includes program agenda, conference syllabus, conference tote bag, refreshments, two breakfasts, one luncheon, two receptions, and full access to the Trade Show. If you require assistance or have special dietary needs, please contact TORCH at (512) 873-0045 or email us at: torch@torchnet.org. Please enter the names and titles as they should appear on the badge:

Additional Attendees	Hospital Name	First / Last Name	Title	Phone Number	Email Address