Presents of Education

in the City of Lights

EDUCATIONAL conference

June 08-09, 2018

Pre-Conference

June 6-7, 2018


Name:*
Address:*
Phone:
-
E-mail:
Employer:
Chapter Affiliation:
Name on Badge:
Print Employer on badge:
National Registry #:

CORE CONFERENCE

Includes educational sessions,  lunches and banquet dinner

*PRICE DOES NOT INCLUDE LANREMT MEMBERSHIP*


INDIVIDUAL CONFERENCE REGISTRATION:
MILITARY RATE For active military personnel. ID required at conference registration.
SQUAD CONFERENCE REGISTRATION
GROUP CONFERENCE REGISTRATION: (5+)

For additional members (more than 4) please supply a separate spread sheet with this data.
Spouse/Partner/Guest Meal

Onsite Conference Fee---------------------------$250.00

Dues Payment



Membership Dues

Pre-Conference Registration



EMS Response to Active Shootings "The Rescue Task Force " SINGLE DAY REGISTRATION"
All Hazards Disaster Response (AHDR) course "SINGLE DAY REGISTRATION"
Bleeding Control Course (open to the public)(Evening Class)

Additional Registration

Please complete for each registrant


Conference Group Registrant #2

Name:(2)
Address:(2)
Phone:(2)
-
E-mail:(2)
Employer:(2)
Chapter Affiliation:(2)
Name on Badge:(2)
Print Employer on badge:(2)
National Registry #:(2)

Conference Group Registrant #3

Name:(3)
Address:(3)
Phone:(3)
-
E-mail:(3)
Employer:(3)
Chapter Affiliation:(3)
Name on Badge:(3)
Print Employer on badge:(3)
National Registry #:(3)

Conference Group Registrant #4

Name:(4)
Address:(4)
Phone:(4)
-
E-mail:(4)
Employer:(4)
Chapter Affiliation:(4)
Name on Badge:(4)
Print Employer on badge:(4)
National Registry #:(4)

Payment



To pay with PayPal

1. Press Submit Button to go to PayPal

2. Complete payment and you will be returned to web page.

If you do not have a PayPal account and want to pay with PayPal

1. Press Submit Button to go to PayPal

2. Set up an account and pay with PayPal.

If you do not have a PayPal account and wish not to pay with PayPal

1. Press Submit Button to go to PayPal

2. Close out the PayPal and send your payment to:

P.O. Box 86456

Baton Rouge, LA 70879-6456

Total:
Word Verification:

Conference Hotel

Chateau Saint Denis Hotel Natchitoches, Louisiana

A block of rooms has been reserved and a special rate of Single and Double Occupancy $109.00 + $4.95 per night for wired and wireless internet access for EMS Conference attendees. The reservation deadline is May 06, 2018. Rooms are limited so early reservations are highly recommended. Make your reservations by calling the Chateau Saint Denis Hotel directly at 318-951-4105 and asking for group rate “LANREMT”.

Hotel Group Reservation Deadline is May 06, 2018