San Antonio Health Literacy Conference

Registration options:

Online Registration

Registration is now OPEN!

Please complete the form in its entirety, shaded information will be included on the public participant roster and all other information will be kept confidential. Complete one form per person, please.

If your organization is registering for a group, please contact our office for a group invoice. You may email Elizabeth De La Fuentes at edela.fuentes@healthcollaborative.net, Elvira Landeros at elvira.landeros@healthcollaborative.net or call (210) 481-2573.

Please note that all credit card payments are accepted and processed through PayPal only. There is an additional fee of $5 for this service. Sorry, no credit card payments will be accepted at the door.

Online Registration Form:

Please do not include me in the roster.

Name*
Position/Title*
Email*
Company Name/ Organization/Affiliation*
Business Address*
City*
State*
ZIP*
Work Phone #*	( ) -
Alternate Phone #	( ) -
Fax #	( ) -
Credentials/Degrees*
Special Requirements (please specify)
Dietary:
Accessibility:
Concurrent Session Signup Check boxes next to sessions you plan to attend
Session 1:
Session 2:
Session 3:
Session 4:
Method of Payment*: Please note your registration is not confirmed until payment has been received. Credit Card/        (An additional $5 convenience charge will be added for this service.) Check/Money Order

* Required areas

Registration by Mail

Please download the registration form here. Mail the completed form to:
The Health Collaborative
816 Camaron St., Suite 2.09
San Antonio, Texas 78212

Please make the check or money order payable to:
The Health Collaborative

Payment in the form of check or money order must accompany the registration form in order for registration to be processed.

Registration by Fax

Please download the registration form here. Fax the completed registration form to (210) 223-0680. Do not submit your registration more than once, we will send a confirmation receipt within 2 business days.

Cancellation Policy

• Notice of cancellation must be received by Friday, October 1, 2010.
• A processing fee of $30 will be applied for each cancellation.
• The registration fee is transferrable but you must contact Elizabeth De La Fuentes or Elvira Landeros at (210) 481-2573 by Friday, October 1, 2010. We will need to confirm the replacement's name and title at the time of request.
• Refunds will not be granted after October 1, 2010. No exceptions will be made.

Written requests for refunds must be sent to The Health Collaborative, Attn: Elizabeth De La Fuentes at edela.fuentes@healthcollaborative.net, Elvira Landeros at elvira.landeros@healthcollaborative.net or by fax to (210) 223-0680. Refunds will be issued no sooner than 45 days following the 6^th Annual San Antonio Health Literacy Conference and will follow the schedule below.

For cancellation requests received:
On or before Friday, October 1, 2010: $30 processing fee.
After October 1, 2010: No refunds will be issued, no exceptions will be made

Cost

The regular registration fee of $99 will apply.

The same pricing applies regardless of registration option. Sorry, no purchase orders are accepted.

Limited student registrations are available. The student registration fee is $50. Please note that student registration cannot be processed online, you must mail or fax the registration form and proof of your student status (i.e. copy of current student ID card).

For additional information, please e-mail Elizabeth De La Fuentes at edela.fuentes@healthcollaborative.net, Elvira Landeros at elvira.landeros@healthcollaborative.net or call (210) 481-2573.