Annual Conference Registration For Attendees - Alabama Hospice and Palliative Care Organization

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2026 Annual Conference

Leadership · Clinical · Regulatory. Please begin by telling us your membership status the form will adjust accordingly.

All registrations are non-refundable but transferrable. Registrations after September 15th subject to $100 late fee.

Are you an AHPCO Member?(Required)

MEMBER CONFERENCE RATES

Days Attending	Member Rate
Full Conference	$600
Two Days	$400
One Day	$200

AHPCO member hospices receive one three-day registration as part of their annual dues.

NON-MEMBER CONFERENCE RATES

Days Attending	Non-Member Rate
Full Conference	$750
Two Days	$550
One Day	$350

Consider AHPCO membership for discounted rates and member benefits.

Member Hospice Details

Are you registering as a Board Member?(Required)

Yes

No

Member Hospice Name(Required)

Organization Details

Organization / Company Name(Required)

Title / Role

Number of Registrations(Required)

Select how many people you are registering. Add details for each below.

Attendee 1

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 2

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 3

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 4

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 5

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 6

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 7

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 8

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 9

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Attendee 10

Name(Required)

Discipline(Required)

RN

LPN

SW

Other

Select RN / LPN / SW or specify Other

Days Attending(Required)

Wednesday

Thursday

Friday

Mailing Address(Required)

Phone(Required)

Email(Required)

T-Shirt Size

Dietary Restrictions

Registration & Payment

Choose your registration type — pricing reflects your membership status.

Registration Type(Required)

Full Conference (3 days)

Two Days

One Day

Registration Fees (all attendees)

Price: $0.00

Total Amount

Payment Method

Check Enclosed

Credit Card (Visa / Mastercard / Amex / Discover)

Please provide an online invoice

Credit Card(Required)

Authorization Signature(Required)

By typing your name, you authorize this registration.

Annual Conference 2026 Registration For Attendees

2026 Annual Conference

MEMBER CONFERENCE RATES

NON-MEMBER CONFERENCE RATES

Member Hospice Details

Organization Details

Attendee 1

Attendee 2

Attendee 3

Attendee 4

Attendee 5

Attendee 6

Attendee 7

Attendee 8

Attendee 9

Attendee 10

Registration & Payment