Registration
  1. Below is the online registration for the National Symposium for Healthcare Executives:
    • Fill out the form below and pay electronically by credit card.
    • - or - Call to register - Sara Patterson (205) 934-1672 or Wendy Price (205) 975-4272.
    Accepting: Visa, MasterCard, American Express and Discover.
    • Note to students: You will receive special registration information from your program.
  2. First Name(*)
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  3. Last Name(*)
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  4. Title (if abbreviating, please do not use a period)(*)
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  5. Preferred Name
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  6. Organization
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  7. Address 1(*)
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  8. Address 2
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  9. City(*)
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  10. State(*)
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  11. Zip(*)
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  12. Phone(*)
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  13. Fax
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  14. Email(*)
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  15. Are you a UAB Alumnus/Alumna?
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  16. Please indicate special needs due to a disability
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  17. REGISTRATION FEE for events of August 5 - 8, 2014
    Select one of the options below
  18. Registration(*)





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  19. Would you like to participate in the Golf Event on August 7? If so, you will be billed a $85 entrance fee at event site.
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  20. The two-day ACHE seminar has a limited enrollment that will be based on the earliest registration dates. The ACHE registration fee includes lunch and a continental breakfast each day.

    The symposium registration fee includes a continental breakfast and lunch each day, and receptions on Wednesday and Friday evenings.

    Please call (205) 934-1672 to receive discounted rates for additional members of the same organization. Team discounts are not available for those attending the ACHE seminar only.
  21. Pay By(*)


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  22. Please enter the following characters:(*)
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  24. If paying online, you will be redirected to a new page to enter credit card information.