First Name
Middle Initial
Last Name
ACHE Credentials
Preferred First Name for Badge
Title
Hospital/Company
Mailing Address
CityStateZIP
Phone
Personal Membership Group
Email

By registering for the convention, the attendee authorizes MHA, its subsidiaries or personal membership groups to use any photographs or videos taken during the course of the convention, which may include use of the attendee's likeness, in promotional materials.

Registration Categories/Fees - Please select the appropriate category.

$150MHA-member hospital employees, trustees and auxilians
$175MHA associate and individual members
$225Individuals from nonmember hospitals, personal membership group members not employed by MHA-member hospitals or organizations (group name will appear on name badge in lieu of company name). Membership in group will be verified.
$50State agency employees
$25Spouse (guest) and students
$425Individuals from non-exhibiting commercial firms
No FeeAttendees from exhibiting or sponsoring firms

MHA Convention Meal Functions - Please check the box for the event(s) you will attend.

Wednesday, November 07, 2018 (PRECONVENTION)
4NC3 p.m."The Mental Health Crisis in Missouri Rural Emergency Rooms: Meeting and Reception - Rural Hospital Council and MHA Psychiatric Network members only
Thursday, November 08, 2018
13$507 p.m.MHA Celebration of Achievement Awards Dinner - everyone welcome
Friday, November 09, 2018
14$287:15 a.m.ACHE Breakfast
15$38NoonMHA Awards Luncheon - everyone welcome

MHA Personal Membership Group Meal Functions - Please select the event(s) you will attend.

Wednesday, November 07, 2018 (PRECONVENTION)
1$2511:45 a.m.MAHA (auxilians) Luncheon
2$2811:45 a.m.MSHCA (attorneys) Meeting/Luncheon - MSHCA members only
3NC11:45 a.m.MAHVRP (volunteer resource professionals) Luncheon - MAHVRP members only
Thursday, November 08, 2018
5$228:30 a.m.MAHA (auxilians) Installation Breakfast
6$1811 a.m.MONL (nurse leaders) Meeting/Luncheon - MONL members only
7NC11:30 a.m.MAHPMM (purchasing) Box Lunch - MAHPMM members only
8NC11:30 a.m.MSHHRA (human resources) Box Lunch - MSHHRA members only
9$2611:45 a.m.MAHA (auxilians) Vendor Luncheon
10NC11:45 a.m.MoAHQ (quality) Member Luncheon - MoAHQ members only
11NCNoonHFMA (financial managers) Luncheon - HFMA members only
12$15NoonMCA (chaplains) Roundtable/Luncheon

Total Fees: $0.00

Total Meals: $0.00

Total Due: $0.00 

Payment Information

Card TypeAmount Authorized $
Card NumberExpires
CVC/CVV2
Cardholder Name
Billing Address
City/State/ZIP

Please contact Janine Haynes at 573/893-3700, ext. 1340, with questions.


ABOUT SSL CERTIFICATES

Missouri Hospital Association • P.O. Box 60 • Jefferson City, MO 65102
Phone: 573/893-3700 • Fax: 573/893-2809 • MHAnet