67th Annual Educational Symposium

Mar 12-15, 2018

Name (Please Print ): CEHA Chapter:

Email Address: REHS#: NEHA Affiliate:
Employer/Organization/School Name: Phone:
Each full-day package includes breakfast, lunch and exhibit hall Viewing
Mail this completed form with your payment* to: Pre-Registration Postmarked after No
CEHA 67th AES (Tuan Nguyen) Discount Feb 23rd REFUNDS
10590 Armstrong Ave, Mather, CA 95655 AFTER
Member Non Member Non
*Check or money order made payable to: 3/02/18
Member Member
California Environmental Health Association (Tax ID #23-7034973) Total
3-Day Package: Tuesday, Wednesday, and Thursday $515 $585 $560 $630
Includes Banquet and Offsite Event!
2-Day Package: Days attending: T☐ W☐ Th ☐ $365 $435 $410 $480
1-Day Package: Day attending: T☐ W☐ Th ☐ $185 $255 $230 $300
Student Rate: (Meals not included): T☐ W☐ Th ☐ $20/day - Member
(Provide proof of full time enrollment)
CEHA Retired Member Rates : T☐ W☐ Th ☐ $365 (3-day) $270 (2-day) $150 (1-day)
Add-on Items
Extra Lunch Ticket: Check Day(s): T☐ W☐ Th ☐ $45/day
“Sponsor a Student”1 Quantity: ___ ($20 Registration only)/ ($95 Registration + meals)
California Auto Museum- “Hot CEHA Night” $25/each
An Offsite event Quantity: ___
“Wild Wild West AES” $70/each
Additional Banquet Tickets: Quantity: ___
New or Renewing Members: Include CEHA membership dues to $59
register at the member rate!
Tax Deductible Contribution to CEHA Scholarship Fund (optional)
Please Select: $10 ☐ $20 ☐ $50 ☐ $100 ☐ Other $ _____ Scholarship Tax ID # 68-0465067
Pre-Conference Workshops: Monday, Mar 12, 2018
Exhibitor Hall Reception – Monday Night 5-7pm. Free with Preconference or 3-day Registration!
Certified Pool Operator (lunch included) $295
HACCP/ ROP (lunch included) $150
Dietary Special Requests: Total Amount Due: $

Double Tree by Hilton | 2001 Point West Way | Sacramento, CA 95815 | 916-929-8855
Book your Hotel room at the discounted rate of $129/night and Register at www.ceha.org
http://doubletree.hilton.com/en/dt/groups/personalized/R/RLSA-DT-AES-20180311/index.jhtml
Self-Parking is $4.00/day

1 Sponsorship money kindly donated in excess of the needs of our student attendees will go to the CEHA 501(c) 3 Scholarship fund, tax ID above.

Need help? Contact us at aes@ceha.org