Annual Symposium Registration "*" indicates required fields 1Registration Information2Accommodations3Registration and Payment AARC NumberYour AARC member number is required for membership discount. Your AARC card may also be requested at registration.Name* First Last Professional CredentialsSelect your credentials. RRT CRT NPS ACCS SDS RPFT CPFT RPSGT MD DO RN Education CredentialsThis field is for special or educational credentials you would like on your name badge.Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code NY County*AlbanyAlleganyBronxBroomeCattaraugusCayugaChautauquaChemungChenangoClintonColumbiaCortlandDelawareDutchessErieEssexFranklinFultonGeneseeGreeneHamiltonHerkimerJeffersonKingsLewisLivingstonMadisonMonroeMontgomeryNassauNew YorkNiagaraOneidaOnondagaOntarioOrangeOrleansOswegoOtsegoPutnamQueensRensselaerRichmondRocklandSaratogaSchenectadySchoharieSchuylerSenecaSt. LawrenceSteubenSuffolkSullivanTiogaTompkinsUlsterWarrenWashingtonWayneWestchesterWyomingYatesEmail* PhoneEmployment InformationFacility / SchoolJob settingAcute care / hospitalCollege / universitySubacute / long term careHome CareSleep labPhysician officeIndustryPFT labOtherJob functionManager / DirectorSupervisorEducation CoordinatorProgram DirectorDirector Clinical EducationEducatorStaff Therapist / TechnicianSales / marketingStudentNurseOtherSpecialty AreaGeneral CareAdult Critical CareContinuing Care / RehabilitationDiagnosticsEducationHome-CareLong-Term CareNeonatal / PediatricsSleepSurface & Air TransportJob setting (other)Identify your alternate job setting. Hotel details Rooms have been blocked at the rate of $79/night in the Hotel for Wednesday, September 19 and Thursday, September 20. You must ask for the NYSSRC room rate to get this discounted rate. Parking is free in the resort parking garage and there is free valet parking. For room reservations, call (315) 829-6870. You must ask for the NYSSRC room rate to get this discounted rate and reservations must be made by August 18, 2024 at 5:00 PM to get the discounted rate.Do you require any special accommodations or dietary restrictions?* No Yes Special AccommodationsPlease identify special accommodations.Where did you hear about this conference?* NYSSRC website Facebook Twitter Email Friend Other Terms and Conditions*+ Non-members may join the AARC at the symposium. The difference between the regular fee and the discounted fee will be applied to the AARC membership. + Early registration discount ends after September 1. + No refunds after September 1. + Payment are made via credit / debit card or PayPal. We accept Visa, MasterCard, or American Express through our secure online payment processing. Only institutional checks will be accepted. No personal checks. + Payment by institutional checks must be received by the conference date or your registration may be void. + Click for our conference cancellations / refunds / privacy policy. + There will be a $5.00 processing fee for all refunds. + Photographs taken during the conference may be used in future NYSSRC publications and promotions. + Any questions please contact us at info@nyssrc.org. I agree to the Terms and Conditions Registration and PaymentI am a registering for* Both days Thursday Friday This field is hidden when viewing the formConference Code CouponCommittee members, Speakers, BOD please use issued code. This field is hidden when viewing the formConference CodeCommittee members, Speakers, BOD please use issued code.Early Bird Registration fee*AARC Member – Two-daysNon-member – Two-daysStudent – Two-daysEarly Bird Registration fee*AARC Member – ThursdayNon-member – ThursdayStudent – ThursdayEarly Bird Registration fee*AARC Member – FridayNon-member – FridayStudent – FridayRegular Registration fee*AARC Member – Two-daysNon-member – Two-daysStudent – Two-daysEarly registration has ended.Regular Registration fee*AARC Member – ThursdayNon-member – ThursdayStudent – ThursdayEarly registration has ended.Regular Registration fee*AARC Member – FridayNon-member – FridayStudent – FridayEarly registration has ended.Total Payment choice*Select belowCredit / Debit CardPayPalInstitutional CheckCredit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Online Payment Service verification When you click submit, you will be directed to the PayPal website to complete your payment. Once your payment is complete, you will be redirected back to the NYSSRC website for a confirmation message.Institutional Payment InformationPayment made by institutional check requires the below information. Complete the fields below for the institution that will be issuing the check for this symposium. Do not use your personal address.Institution Name*Department Name*Department or division nameAddress* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneCommentsThis field is for validation purposes and should be left unchanged.
