general - The National Association of State EMS Officials

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					                       National Association of State EMS Officials
                       Annual Meeting General Registration Form
                       September 21 – 25, 2008 ● Hotel Murano, Tacoma, WA

Program:                        Who should attend: members of NASEMSO and other state and federal officials with a role in
Posted at                       emergency medical services; EMS suppliers.
                                The NASEMSO Annual Meeting purpose is to address current issues and trends in emergency
Registration Fee:               medical services systems.
$385.00                              For more information: 703-538-1799
$140.00 spouse/guest            Select your                          Name:                                     Nickname:
(cover meal expenses)
                                registration:                        Title:

Program                            payment mailed
                                   please invoice me                 Address:
Handouts, breaks, (1)              please use credit card
continental breakfast,                                               City/St/Zip:
(2) lunches, and                Amount :
receptions.                                                          Phone:                                     Fax:

Accommodations: Council Meetings:

Hotel Murano         Are you planning to attend
                                                                     Spouse/Guest:                             Nickname:
1320 Broadway Plaza  the forum for:
Tacoma, WA 98402        state EMS director
(253) 238-8000          data manager
                        EMSC coordinator                             Payment                 Check (payable to NASEMSO – U.S. funds only)
Group Name:
                        medical director                             Method:                 Purchase order
                        trauma manager                                                          Visa         MasterCard     AmEx
NASEMSO or National     training coordinator
Association of State
EMS Officials                                                        Name on card:
                     Are you only attending the
                                council meeting and not the Card number:
Room Rate:                      rest of the NASEMSO
$165 + tax                      Program?                    Security Code (located on the front or back of the credit card)
single/double                      Yes        No
                                                                     Exp. Date:                                  Signature:
                                Registration Fee for Council         Credit Card Billing Address:
To receive this special         Meeting Attendance Only:
room rate contact the             $75.00
hotel by Aug. 20, 2008.                                              Cancellations received 14 days prior to the event will be granted a 50% refund.
                                                                     No refund or credit will be granted for requests received less than 14 calendar
                                Optional Activities:                 days prior to the event. If you do not cancel your registration in writing and do
                                   I will attend Sun.-Mon.,          not attend, full fees are due; you may however, send a substitute in your place.
NASEMSO rates $40 R/T
                                Sept 21-22 Leadership Skills         Participation in NASEMSO events and all associated activities is at individual’s
from SEA via Capital
                                for State EMS Officials              own risk.
Aeroporter Airport
Shuttle. Book online—           session (no add’l. fee)
click here. OR go to                                                          Fax, mail, or email this form to: and click           Mon., Sept. 22 Space                NASEMSO ● 201 Park Washington Ct. ● Falls Church, VA 22046
on the Reservations             Needle Tour/Dinner - $70                     Fax: 703-241-5603 ● Phone: 703-538-1799
button. Once there, enter       pp. See                         
the code EMS in the             for tour offering sign up
Group, Frequent User ID         form.
box at the bottom of the

G:/NASEMSO/Meetings/Annual/2008/08 Registration Materials (General).doc\08-08-08
                                NASEMSO 2008 ANNUAL MEETING
       Space Needle Monday, September 22, 2008 Optional Outing
                            Sign-up Form

The anticipation begins on the ground the moment your eyes and your imagination take in the magnificence of the
iconic structure you’ve seen only in pictures. The Space Needle elevator propels you to the Observation Deck,
520 feet above ground. On this vertical voyage, you will from 0 to "Wow" in 41 seconds. 10 seconds: See the
sparkling waters of Puget Sound…20 seconds: Mt. Rainier becomes a huge snow cone…30 seconds:
Skyscrapers appear like giant Legos …41 seconds: You're saying "Ohhhhhhhh" as you take in Seattle’s sights
from the Observation Deck, followed by dinner with an unforgettable view at the 100 foot Skyline Level of the
Space Needle.

The $70.00 per person cost includes admission to the Space Needle’s observation
deck, dinner and bus transportation. A cash bar will be available for purchase of
cocktails, beer, wine and soft drinks.

Programming the optional outing for Monday is a deviation from the traditional
Annual Meeting scheduling practice of organizing it for Thursday evening. The
intention of this change is to provide the opportunity for more attendees to

The deadline to sign up for this outing is Tuesday, September 16, due to the Space Needle’s requirement
for our final headcount no later than Wednesday morning, September 17.

We will depart the hotel at 4:30 p.m. and return by 9:30 p.m.

                                    PLEASE COMPLETE AND RETURN WITH PAYMENT TO:
        NASEMSO • 201 PARK WASHINGTON COURT • FALLS CHURCH, VA 22046 • FAX 703/241-5603
Via mail: 201 Park Washington Court, Falls Church, VA 22046
Via fax:         703/241-5603
Via email:

The $70.00 per person cost includes admission to the Space Needle’s observation deck, dinner and bus
transportation. A cash bar will be available for purchase of cocktails, beer, wine and soft drinks.

         # of participants @ $70.00 per person                   Method of Payment:     Check    Credit Card

Charge to my credit card $                                     Card Type (check one):   VISA    MasterCard     AmEx
Card #                 Expiration Date                    V-code #*
Billing Address for Credit Card:
Name on Card                     Signature & Date

*VISA and MasterCard – 3 digit number on back of card; AmEx – 4 digit number on front of card.

Your Name

G/NASEMSO/meetings/2008 annual meeting/optional outing flyer

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