Michigan Industrial Hygiene Society Event Registration Form Yes! I want to attend the following MIHS Event(s)

Past Presidents' Breakfast and Annual Meeting (2 Hour PDC) March 29, 2012- Schoolcraft College - Vista Tech Center - Room W210B Registration and Breakfast begin at 7:45 a.m. Type of Registration Student - $10/person Breakfast/PDC Past Presidents - FREE Members - $25.00/person Breakfast/PDC Non-Members - $40.00/person Breakfast/PDC Enter your contact information below: Email Address* Name* Telephone* Company Address City State Zip Code Additional Attendees List Names and Emails for each attendee on the same line. Addons Listed Comments Check the Event(s) you would like to attend below: Total Registered* Please enter the phrase as it is shown in the box above.

MIHS promises not to use this information in any manner inconsistent with the purpose intended. We will require your E-mail address to contact you with assistance.  IMPORTANT NOTE: MIHS relies on the number of people who register for an event to attend it. If a person registers and doesn't attend, it may make the difference between breaking-even or losing money for an event. MIHS makes every effort to cover the costs of the event through the registration fees. As little as a half dozen people who register for an event, but do not attend it, may make the difference between the break-even point and losing money. Therefore, the Board decided that if you register for an event, but do not attend it, you will still be charged for the event, if you do not cancel 7 or more days prior to the event.