Advance Registration Form
Deadline:August 30, 2017

Register online below or by mail with this registration form (PDF)

Having problems registering for the conference? For Help and Support with applying or renewing for membership online or conference registration, please email our support at or call at 646 226 4073 

First Name*:
  Last Name*:


Title*: Organization*:

Work Address : Address Line 2:

City: State: Zip:

Office Phone Fax Email

Do you prefer a vegetarian meal for the two luncheons? Yes                No

: Includes all educational sessions, meetings, luncheons, and Thursday evening reception.

Please Choose Member or Non-Member next or your registration will be incomplete.

TPHA Member $150 ($200 after Aug 30, 2017)

: If space is available - registrants for entire conference receive priority. Do NOT register for individual functions if you have registered for the full conference.
Wednesday September 13, 2017  
Sessions (includes lunch)
Thursday September 14, 2017  
Sessions (includes Lunch)
President's Reception
Friday September 15, 2017  
Sessions $45*                              $55*
 *$10 will be added to each function for registrations after  
   August 30, 2017   
Workshops only (Advance registration required by August 30, 2017 $0.00)  
Additional Guest Tickets  
Thursday Evening Reception tickets: @ $50 each                                    

TPHA Membership Dues  
First-time new member....... $30
Renewal Membership ..... $40 (includes $10 late fee)            
I have reviewed my registration information for accuracy and agree that all is correct.  

On the next screen please make sure billing address and zip code matches what is on file for the card.