Education Conference Registration

Return completed form to: NHASEA, 25 Triangle Park Drive, Suite 103, Concord, NH 03301 or fax to 224-0684


  • Use one registration form for each person attending
  • Online registration at or mail or fax registration. See above for address and fax number.
  • You will receive an email confirmation when registration is received
  • Registration fees are non-refundable after March 1, 2018
  • No-shows and cancellations will be billed at the full rate

Check all that apply. At least one selection required.
Check all that apply. At least one selection required.

Conference Fees/Payment:

Payment or purchase order must accompany registration

  • $180.00 per person/per day
  • $320.00 per person/two days
  • $50.00 per person late registration fee (Received after March 1) will be accepted space permitting.
Please describe any special accommodations you may require:

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