West Virginia Academy of Nutrition and Dietetics

Complete the Registration Information below. Click PAY NOW at the bottom of the form to complete your registration.

Contact Information

First Name Last Name Credentials Name to appear on badge Academy membership # Street Address Street Address 2 City State ZIP Day Phone Fax E-mail Address Job Title Employer Any Special Needs?

Registration Information

Membership Status

You must be a member of the Academy of Nutrition and Dietetics Association to receive the member registration rate.
Choose Member type:
Academy Member Non Member Student Member Retired Member

Registration Status	Academy Member*	Non-Member	Student Member **	Retired Member
Please check your selection:
2-Day Registration: May 13 and 14, 2014 (includes lunch on Wednesday only)	$200	$300	$0	$0
Tuesday Only Registration: May 13, 2014 (lunch NOT included)	$110	$165	$0	$0
Wednesday Only Registration: May 14, 2014 (lunch provided)	$110	$165	$0	$0
Student Social at Heston Farm	$20	$20	$20	$20

Please click the Pay Now link below to complete your registration through PayPal. NOTE: Even if your registration is **free**, please click the Pay Now link to complete your registration and you will not be charged.

By Clicking Pay Now above, you will be taken to the PayPal Payment Center where you can pay with an existing PayPal account. Don't have a PayPal account or do not want to use your existing PayPal account? From the PayPal Payment Center, choose the option that says "Use your credit card or bank account (where available)" to pay with a credit card.

*Valid ADA Membership cards are required at time of registration.
**Students must be full time with documentation from advisor and pre-registered.
Questions?: Heather Dyston, dysonh@wvuhealthcare.com or via phone: 304-594-1313, or Anna Davis, Anna.Davis@healthsouth.com.