2012 WVDA Annual Meeting Registration Form

Pre-Registration Deadline for Educational Sessions: May 8, 2012
Pre-Registration Deadline for Board Meeting and Gala: May 6, 2012.
NOTE: Due to room capacity, the gala is limited to the first 125 people to register.

Complete the Registration Information below. Click PAY NOW to complete your registration.

Contact Information

First Name Last Name Credentials Name to appear on badge Academy membership # Street Address Street Address 2 City State ZIP Day Phone Fax E-mail Address Job Title Employer Any Special Needs? Vegetarian Meal Yes No
(Vegetarian meals must be specified on registration form. Meal preferences can not be accommodated on-site.)

Registration Information

Membership Status

You must be a member of the Academy of Nutrition and Dietetics Association to receive the member registration rate.
Choose Member type:
Academy Member Non Member Student Member Retired Member

Registration Status	Academy Member*	Non-Member	Student Member **	Retired Member
Please check your selection:
Tuesday Executive Board Meeting: May 15, 2012 (includes dinner)	$0	Members Only	$0	$0
Gala: May 16, 2012 (Open to first 125 who register)	$40	$40	$40	$0
2 Day Registration: May 16 and 17, 2012 (Does not include gala)	$170 (gala not included)	$250	$0	$0
Wednesday Only Registration: May 16, 2012 (Includes $6 meal ticket for lunch)	$95	$140	$0	$0
Thursday Only Registration: May 17, 2012 (Includes box meal)	$95	$140	$0	$0

Please click the Pay Now link below to complete your registration through PayPal. NOTE: Even if your registration is **free**, please click the Pay Now link to complete your registration and you will not be charged.

By Clicking Pay Now above, you will be taken to the PayPal Payment Center where you can pay with an existing PayPal account. Don't have a PayPal account or do not want to use your existing PayPal account? From the PayPal Payment Center, choose the option that says "Use your credit card or bank account (where available)" to pay with a credit card.

Lodging Information

Group Name: WV Academy of Nutrition and Dietetics
Group Code: WVA
Check-in: 15-MAY-2012
Check-out: 17-MAY-2012
Hotel Name: Hilton Garden Inn Morgantown

Hotel Address:
150 Suncrest Towne Center Drive
Morgantown, West Virginia 26505
For GPS tracking, the address to use is 500 Suncrest Towne Center Drive; Morgantown, WV 26505
Phone Number: 3042259500

Hotel Registration Site

*Valid ADA Membership cards are required at time of registration.
**Students must be full time with documentation from advisor and pre-registered.
Questions?: Cindy Gay, gayc@wvuhealthcare.com (weekdays til 3), or cndgay@comcast.net (after 3 and on weekends), or via phone: 304-598-6306 (weekdays till 3).

Five Reasons to Visit Your Local Farmers' Market:

You are supporting local farmers
Fresh produce (with lots of variety from different vendors)
Less energy is used in getting the produce to the market
It's a good opportunity to socialize with others in the community
It's cheaper!

Be sure to check out some of our favorite Recipes