Registration Form - New York State Public Health Association

New York State Public Health Association
2015 Annual Meeting and Conference
“Creating Healthy Places”
April 23 – 24, 2015
The Sagamore Resort
Bolton Landing, NY
Conference Registration
New York State Public Health Association
2015 Annual Meeting and Conference
Join NYSPHA for our 65th Annual Meeting and Conference
Please save the date and join us for a leading edge, two-day public health conference on
Thursday, April 23rd and Friday, April 24th, 2015.
The annual meeting will offer scientific sessions in a variety of formats including large plenary
sessions and smaller concurrent sessions. Sessions will focus on issues and topics relevant to this
year’s theme of “Creating Healthy Places.”
This conference is designed for public health educators, academic staff, county health
officials and employees, students, medical and dental practitioners, state health employees
and others in the field of public health, education and medical care. We welcome all
individuals and organizations who share a common interest of promoting and protecting the
public’s health.
Breakout workshops, pre-conference workshop information and plenary session speakers will be
announced soon.
Register Today
Use the accompanying form to register via the US Postal Service or register online at
www.nyspha.org
Continuing Education
The 2015 Annual Meeting is currently under review for continuing education hours for 10 CHES
entry-level credits, 6 MCHES advanced level credits, and 10 CPH credits. Full credits are based on
attendance at both the pre-conference workshop and annual meeting.
Partial credits may be available for individual events. Additional details coming soon.
Professionals seeking continuing education credits not listed above will be provided a completion
certificate upon request for self-submission.
New York State Public Health Association
2015 Annual Meeting and Conference
Join us for an innovative and informative program. Learn from experts who have studied public
health issues in communities and from those who have made successful changes. Below please
find a tentative agenda; details on topics and presenters coming soon.
April 23, 2015: Day 1 Agenda
New York State Public Health Association Annual Meeting & Reception
“Creating Healthy Places”
8:30 AM – 6:30 PM The Sagamore Resort, Bolton Landing, NY
____________________________________________
Pre-Conference Workshop
8:30 AM – 9:00 AM
Pre-Conference Workshop Registration
9:00 AM – 1:00 PM
Pre-Conference Workshop (lunch included)
__________________________________
Annual Meeting
1:00 – 1:30 PM Conference Registration
1:30 PM – 2:30 PM Welcome
2:30 PM – 3:30 PM
3:30 PM – 4:30 PM
4:30- 6:00 PM
Exhibitors, Posters, Networking
Concurrent Breakout Sessions
Breakout A
Breakout B
Reception & Awards (included with Annual Meeting registration)
April 24, 2015: Day 2 Agenda
New York State Public Health Association Annual Meeting
“Creating Healthy Places”
8:30 AM- 9:00 AM
Registration
9:00 AM – 10:30 AM Welcome
10:30 AM – 11:00 AM Exhibitors and Networking
11:00 AM- 12:00 PM Concurrent Breakout Sessions
Breakout C
Breakout D
12:00 PM – 1:15 PM Luncheon (provided)
New York State Public Health Association
2015 Annual Meeting and Conference
1:15 PM – 1:30 PM
Networking
1:30 PM - 2:30 PM
Concurrent Breakout Sessions
Breakout E
Breakout F
2:30 PM – 2:45 PM
Exhibitors and Networking
2:45 PM – 3:45 PM
Concurrent Breakout Sessions
Breakout G
Breakout H
Details and descriptions of workshops and presenters coming soon.
______________________________________________________
Hotel Information
All events will take place at The Sagamore Resort in Bolton Landing, New York. A block of rooms
has been reserved for Wednesday, April 22nd, 2015 and Thursday, April 23rd, 2015. Please call
1-866- 385-6221 to reserve a room by March 23rd under the group promo code NYSPH0415 for a
group rate of $99/night for standard rooms or $199/night for suites. Discounted rates are subject to
a taxed resort fee of $10 per room per day. Find out more information about The Sagamore Resort
at www.thesagamore.com.
Transfer/Cancellation Policy
If you registered for the conference and cannot attend, you may transfer your registration to
another person. All transfer/cancellation requests must be submitted in writing and received by
NYSPHA no later than April 18th, 2015. Please submit your request via email to info@nyspha.org.
 Cancellations received on or before April 18th, 2015 will be refunded minus a $10
administrative fee.
 Cancellations received April 19th, 2015 or later are not refundable.
 Space at each event is limited - no-shows will be charged the full registration fee.
Important Information
Nearest Airport- The Sagamore is located on Lake George at 110 Sagamore Road, Bolton
Landing, New York 12814. The resort is accessible by air to Albany International Airport, by Amtrak
from New York and Montreal, the closest rail station being the Albany-Rensselaer location, and by
automobile via Interstate 87 (the Northway). The Sagamore is within a short drive of most MidAtlantic, New England, Quebec and Ontario Province metropolitan areas. For additional
information visit: http://www.thesagamore.com/directions/
Hotel Parking- Parking is free at The Sagamore Resort.
Food & Beverage- Lunch and coffee breaks are included with your registration fee. The
Sagamore’s chef has designed a menu to meet the “Healthy Meeting Guidelines” recommended by
the New York State Department of Health. Gluten-free options will also be available.
New York State Public Health Association
2015 Annual Meeting and Conference
Conference Attire- Please keep in mind that meeting room temperatures vary. You may want to
bring a jacket or sweater to all sessions.
Payment Information- Registration fees may be paid via credit card (via PayPal) online only or
offline via check or purchase order. Registration on-site is available but telephone confirmation is
recommended as space is limited.
Exhibit- Become an Exhibitor at the 2015 Annual Meeting. Email info@nyspha.org for more
information or download a sponsor/exhibitor packet at www.nyspha.org.
Event and Registration Questions- Contact us with any questions by phone or email:
Tel: (518) 427-5835 Email: info@nyspha.org
New York State Public Health Association
2015 Annual Meeting and Conference
Registration Form
Registration may also be completed online at http://www.NYSPHA.org
Name:_______________________________________________________
Title: ________________________________________________________
Organization Name: ____________________________________________
Address: _____________________________________________________
_____________________________________________________
County: ____________________Phone: ____________________________
Email: _______________________________________
Do you have a NYSPHA membership through April 24, 2015? ___________
Continuing Education Credits Requested:
____ CHES/MCHES ____CPH
AMOUNT
Pre-Conference Workshop- 9 AM- 1 PM April 23, 2015 (includes lunch)
NYSPHA Member…………………………………………......……….$65
$_______
$_______
Non-Member …………………………………………………….........$80
Annual Meeting - April 23-24, 2015 (includes lunch and reception)
Early Bird (by 1/30/15): NYSPHA Member…..………......$125
$_______
NYSPHA Member……………………………………………......……$140
NYSPHA Student Member………………………………......……$75
Early Bird (by 1/30/15): Non-NYSPHA Member…….....$160
Non-NYSPHA Member…………………………………….....…...$175
Non-NYSPHA Student Member……………………......………$90
Join NYSPHA Now or Renew Your Membership
$_______
Student Membership………………………………………..........$25
Reduced Income Membership ………………………….........$40
Individual Membership ……………………………….…..........$75
Organizational Membership…………………………….......…$250
Total Due $
Please mail completed registration form and payment of check (payable to NYSPHA)
or purchase order to:
NYSPHA, PO Box 38127, Albany, NY 12203
Questions? Call or email us at (518) 427-5835 or info@nyspha.org