HOTSymposium Registration

HOTSymposium

WHERE: Emergency Services Education Center
7601 Steinbeck Bend
Waco, Texas 76708
WHEN: June 21, 2018
TIME: 8:00am - 5:00pm
(Light Breakfast and Lunch will be provided)

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* 1. Please complete the following:

First Name:

Last Name:

Company:

Position:

Phone:

Email:

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* 2. HOTRAC Member Entity

Yes

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* 3. Please check the type of CE required. Prices below are for RAC Members. Non-RAC members will pay an additional $30 fee.

CME - $110

CNE - $85

EMS - $55

None - $35

MCC EMS Education Student

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* 4. The registration fee for this Symposium is $50. Please indicate your payment option below:

I will send a check. Make check payable to HOTRAC and mail to HOTRAC at 2911 Herring Avenue, Suite 100, Waco, TX 76708

I would like to pay with a credit card. A $5 fee applies. An invoice will be sent to the email address listed above with directions for payment.

I would like to pay via PayPal. A $5 fee will be applied. A link for payment will be sent to the email address listed above.

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* 5. I have special considerations for food. Please list below.

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* 6. By entering my name and date below, I understand that there will be no refunds after June 10, 2018.

Name:

Date: