2009 WAHPERD Convention Pre-registration Form
Deadline: October 8th, 2009

You must be a current member of WAHPERD through 11/09 to pre-register for the convention. COMPLETE ALL INFORMATION IN STEP 1 AND CHECK ALL APPROPRIATE FEES IN STEP 2. You can verify your membership status by calling the WAHPERD office at 608-785-8175 or 800-441-4568. You may obtain a membership application by clicking here.

Convention pre-registration requires two steps. The first is to send us your registration information. The second is to make a secure online payment for registration and fees.

STEP 1: SEND US YOUR REGISTRATION INFORMATION

First Name:           Last Name:
Street:
City, State, Zip:
Phone (Home):           Phone (Office):
E-mail Address:
Student          Teacher          Other
University or School District:

Is this your first WAHPERD convention? Yes    No
WAHPERD District (check one): NW     C     NE     SE     SC     SW     E