National Consumer Voice

First Name *

Last Name *

Title

Organization

Address *

Address 2

Apartment / Suite #

City / Town *

State

Zip Code *

Country (if different than United States)

Email *

Verify Email *

Phone

Area Code

Phone Number

Phone

Area Code

Phone Number

Race / Ethnicity

I prefer to opt out of the meetings public directory.

Check if your billing address is different from your mailing address

Billing Address

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Please check all that apply

Special Accomodations

I need special accommodations (e.g. vegetarian meals).

Other Notes

Everyone who registers will be automatically added to the Consumer Voice Action Network e-mail list.

Total Registration and Optional Fees Due:

Attendee Type	CV Member	Non-Member	Long-Term Care Consumers (Residents)
~~Early: by 7/31~~	~~$450~~	~~$595~~	~~Free~~
~~Regular: until 10/13~~	~~$495~~	~~$650~~	~~Free~~
Late: after 10/13	$550	$695	Free
One-day Attendance	$275	$325	Free

Your Attendance Choice *

Consumer Voice Members - $550.00
Non Members (If you plan on purchasing a membership with your registration, choose the member rate instead of 'non member' rate) - $695.00
Long-Term Care Consumers (Residents) - $0.00
One-day Attendance - Member - $275.00
One-day Attendance - Non-Member (If you plan on purchasing a membership with your registration, choose the member rate instead of 'non member' rate) - $325.00

Check here if you want to become a new Consumer Voice member or to renew your existing membership.

Pre-Conference Intensives:

Pre-conference intensives will be offered on Sunday , November 5th from 1:00pm-4:00pm. "Nursing Home Satisfaction Measures: What is Their Relationship to Quality?" is offered free of charge as part of a grant. "Ombudsman Volunteer Management" is $60. Please indicate below if you would like to attend an intensive.

Please select below if you would like to attend this intensive:

Ombudsman Volunteer Management - $60.00
Nursing Home Satisfaction Measures: What is Their Relationship to Quality? - $0.00

Additional Options

Meals

The following are included with your conference registration

Sunday (11/5)	Monday (11/6)	Tuesday (11/7)
Evening Reception	Box Lunch, Coffee Breaks and Awards Ceremony and Reception	Plated Lunch , and Coffee Breaks

Program on Capitol Hill

On Wednesday, November 8th, conference attendees will head to Capitol Hill for a Consumer Voice sponsored plenary, “Achieving the Promise of the Nursing Home Reform Law 30 Years Later: Moving Forward Together,” being held from 10:00am – 12:00pm. Attendees who are interested may set up visits with your members of Congress. More information can be found here.

Do you plan to attend the program on Capitol Hill on Wednesday? *

Yes
No
Undecided

Help Bring Consumers to the Conference

Making the consumer voice heard is integral to our mission and to our annual conference. Your contribution can help residents and long-term care consumers attend our conference. Donors supporting consumer attendance at the conference will be acknowledged in the program book and at the conference.

Donation:

Contribute towards lunch for a consumer during the Resident Luncheon - $45.00
Contribute towards the cost of certified aides to assist consumers at the conference - $65.00
Contribute towards the cost of accessible vans to transport consumers to the conference - $100.00

Please contact me about conference sponsorship opportunities!

Register as part of a Group?

Name of Group

Voucher Code

(only applicable to scholarship recipients, conference sponsors, groups and speakers)

Total

$0.00

Registration Payment Method

To pay by check or money order, please click the button below. We will send you a receipt by e-mail; please print, sign and return with your check to the address given on the receipt.

Payment by Check or Money Order
Payment by Credit or Debit Card

Registration Cancellation Policy: All cancellation requests for registration must be made in writing. A refund, minus a $100.00 processing fee, will be made for each request dated prior to October 30, 2017. No registration refunds will be issued after October 30th. Attendees must cancel their own hotel reservations according to the hotel’s cancellation policy or incur any applicable fees.

CAPTCHA

Please enter the word you see in the image

2017 Consumer Voice Annual Conference