2023 Annual NYSASN ConferenceRegistration Form Please enable JavaScript in your browser to complete this form.A space has become available and we are pleased to be able to accept your registration for NYSASN's 2023 Conference.NameFirst Name *Last Name *Email *PhoneCell/Home Phone *Work Phone *School InformationSchool District *For independent school, enter school name.RN License # *If you do not have an RN license number, enter N/A.Registration Type *NYSASN Member - $200.00Non-Member - $250.00Add one guest (Banquet Only) - $50.00Add second guest (Banquet Only) - $50.00Do you have a coupon code? *SelectYesNoAnswer YES if you have been provided with a coupon code. Answer NO if you do not have a coupon code. (You must make a selection.) If your code is accepted your discount will be applied. If your code is invalid no discount will be applied.Coupon CodeNYSASN Member - $200.00NYSASN Member - $0 (BOD)NYSASN Member - $140.00 (Discounted)Non-Member - $250.00As a board member your conference registration is 100% discounted. Thank you for your hard work!Welcome new member! Your code entitles you to $60 off of the NYSASN member registration fee.Banquet Only (One Guest) - $50Banquet Only (Second Guest) - $50 Payment Method *PayPal/Credit CardCheck or Money OrderPurchase Order (Please provide accounts payable contact information below.)Check/money order payment is due in full no later than April 7, 2023. Mail your payment to: O. Jeanne Dolly, Registrar 81 Rowley Street Gouverneur, NY 13642Name of primary billing contact *FirstLastBilling Phone *Billing Email *For check/money order or purchase order payment, you will be redirected to the confirmation screen after clicking "Submit." For credit card/PayPal, you will be taken to the PayPal screen to complete your transaction. Click "Return to Merchant" to be redirected to the confirmation screen. In addition to the onscreen confirmation message, you will also receive a confirmation email, once your registration is submitted, and in the case of PayPal, once your payment has been processed. Please contact the registrar directly if you have not received the confirmation email.Total$ 0.00Submit