Test 1 – The Hebets Company

Step 1 of 15

Hidden

Hide 2nd page

Yes

Hidden

Registration Token

Hidden

Attendee Web Domain

Hidden

Attendee Email Domain

Hidden

Attendee Email Address

Hidden

Attendee (Contact Record ID)

Hidden

Attendee (Marketing Record ID)

Hidden

Event ID

Hidden

Event Name

Hidden

Event Day

Hidden

Event Month

Hidden

Event Year

Hidden

Starting Marketing Campaign Name

Hidden

Starting Marketing Campaign ID

First Name(Required)

Last Name(Required)

Email Address(Required)

Mobile Number(Required)

Title(Required)

Organization(Required)

Do you have an Executive Assistant?(Required)

Yes

Executive Assistant First Name

Executive Assistant Last Name

Executive Assistant Email Address

Executive Assistant Mobile Number

Full Name(Required)

Prefix First Name Last Name Designations (optional)

Please confirm your name prefix/title and feel free to provide any professional designation you might have.

Example: , SHRM-CP

Full Name

Postion & Organization/Company

is headquartered in (City):

is headquartered in (State):

Name Confirmation

Looks good!

Guest Registration | Would you like to bring a personal guest, ?

Your personal guest, spouse or significant other have full access to the symposium.

Would you like to bring a spouse or significant other?

Yes

Personal Guest for

We will ask for their contact details and information later on this registration form. Please be sure to have their email address and mobile number handy.

Click Next when ready.

Registration | How many Executive Guest(s) would you like to bring?

Each organization that is invited may bring up to two executive leaders or key board members (i.e. board chair, committee chair, etc.) to attend on a complimentary basis.

If you would like to bring more than two executive guests, please indicate that below, and continue to register your two complimentary executive guests.

How many Executive Guest(s) from would you like to bring?

No Executive Guest

One Executive Guest

Two Executive Guests

More than Two Executive Guests

Approval Needed

You have selected to bring more than two executive guests.

In the message field below, please explain a bit more about your organization, and why you would like to bring more than two executive guests.

On the next page please continue the registration for your two approved executive guests.

Send message to (Name):

First Last

Send message to (Email):

Please let us know more about your organization and why you would like to bring more than two executive guests?(Required)

Registration | Executive Guest(s)

Each organization that is invited may bring executive leaders or key board members (i.e. board chair, committee chair, etc.) to attend on a complimentary basis.

1st Executive Guest First Name

1st Executive Guest Last Name

2nd Executive Guest First Name

2nd Executive Guest Last Name

Registration | 1st Executive Guest

's Email Address

(Executive Guest for )

's Mobile Number

(Executive Guest for )

What is 's title?

Does also work for/represent ?

Yes

No, they work for another organization in the community

What organization does represent?

Registration | 2nd Executive Guest

's Email Address

(Executive Guest for )

's Mobile Number

(Executive Guest for )

What is 's title?

Does also work for/represent ?

Yes

No, they work for another organization in the community

What organization does represent?

Event Hub Invitation for

Once we complete your event hub registration, we will send an invite link to your executive guest, . Once they receive this invite link, they will be able to complete their own registration.

Does 's email address look correct?

You can adjust here if need be.

Confirmation(Required)

Yes, looks good!

Event Hub Invitation for

Once we complete your event hub registration, we will send an invite link to your executive guest, . Once they receive this invite link, they will be able to complete their own registration.

Does 's email address look correct?

You can adjust here if need be.

Confirmation(Required)

Yes, looks good!

Registration for your spouse/significant other. Personal Guest for .

In addition to your executive guest(s), you are also invited to bring a personal guest.

Personal Guest First Name

Guest of

Personal Guest Last Name

Guest of

's Email Address

(Guest for )

's Mobile Number

(Guest for )

Would you like to include 's professional title and company on their symposium registration?

Yes

What is 's title?

What organization/company does work for/represent?

I will be attending the following ( ):

Wednesday (12/6) Cocktail Reception & Dinner at 6 PM

Thursday (12/7) Breakfast at 7 AM

Thursday (12/7) Lunch at 12 PM

Thursday (12/7) Dinner at 6 PM

Friday (12/8) Breakfast at 7 AM

Friday (12/8) Lunch at 11 AM

Dietary requirements for :

Yes

What are your dietary requirements, ?(Required)

will be attending:

Wednesday (12/6) Cocktail Reception & Dinner at 6 PM

Thursday (12/7) Breakfast at 7 AM

Thursday (12/7) Lunch at 12 PM

Thursday (12/7) Dinner at 6 PM

Friday (12/8) Breakfast at 7 AM

Friday (12/8) Lunch at 11 AM

Guest of

Dietary requirements for :

Yes

What are 's dietary requirements?(Required)

Hotel Registration - Royal Palms Resort and Spa

As an Invited guest you receive two complimentary nights at The Royal Palms Resort during our Symposium, Wednesday December 6th and Thursday December 7th.

Room and tax charge is paid for by The Hebets Company.

Would you like to secure your complimentary two nights at The Royal Palms Resort?

Yes

No, I have other accommodations

Would you like to extend your stay at The Royal Palms Resort?

Yes, I would like to extend my stay for an additional cost

No, I would just like my complimentary two night stay during the symposium

Check-in date:

MM slash DD slash YYYY

Check-out date:

MM slash DD slash YYYY

Check-in date:

MM slash DD slash YYYY

Check-out date:

MM slash DD slash YYYY

Extended Hotel Room Rate Charge

If yes, Sharon Parrish from The Hebets Company will confirm dates and pricing with you before any charges are assessed.

Note: The current room rate to extend your stay at The Royal Palms is $464 USD per night (subject to change/availability).

Symposium Travel Suggestions

Arrivals: Hotel check-in 4pm with welcome reception/dinner, Wednesday December 6th at 6pm.
Departures: Event ends on Friday, December 8th at 12pm. Hotel check-out is 12:15pm.

All times are MST.

Room rates for pre/post symposium are $464. I am responsible for additional night stays outside of 12/06/2023 - 12/08/2023.

I understand

Contact Data Fields - Confirmation

Hidden

Attendee First Name

Hidden

Attendee Last Name

Hidden

Attendee Full Name

Prefix First Nane Last Name Designations (optional)

Hidden

Attendee Email Address (Preferred)

Hidden

Attendee Phone Number (Mobile)

Hidden

Attendee Organization/Company

Hidden

Attendee Job Title

Attendee Organization/Company City

Attendee Organization/Company State

Name Details/Organization/Company Confirmation

Attendee Executive Assistant (Yes/No)

Attendee Executive Assistant First Name

Attendee Executive Assistant Last Name

Attendee Executive Assistant Email Address

Attendee Executive Assistant Phone Number (Mobile)

Attendee Executive Guest - 1st Executive Guest First Name

Attendee Executive Guest - 1st Executive Guest Last Name

Attendee Executive Guest - 1st Executive Guest Email Address (Preferred)

Attendee Executive Guest - 1st Executive Guest Phone Number (Mobile)

Attendee Executive Guest - 1st Executive Guest Job Title

Attendee Executive Guest - 1st Executive Guest Organization/Company

Attendee Executive Guest (2nd Executive Guest First Name)

Attendee Executive Guest (2nd Executive Guest Last Name)

Attendee Executive Guest - 2nd Executive Guest Email Address (Preferred)

Attendee Executive Guest - 2nd Executive Guest Phone Number (Mobile)

Attendee Executive Guest - 2nd Executive Guest Job Title

Attendee Executive Guest - 2nd Executive Guest Organization/Company

Attendee Personal Guest First Name

Attendee Personal Guest Last Name

Attendee Personal Guest Email Address (Preferred)

Attendee Personal Guest Phone Number (Mobile)

Attendee Personal Guest Title (Personal Title)

Attendee Personal Guest Title (Professional Title)

Attendee Personal Guest Title (Organization/Company)

RSVP Confirmation

Yes, submit my registration!

Hidden

Email to go out to EG

cc - add main guest to email notification Hi, #fname. Your colleague, #guestName has requested for you to attend The Hebets Company 5th Annual Educational Symposium for Non-Profit Healthcare Organizations, as their executive guest. Cutting Edge Trends in Executive Compensation: How to Attract and Retain Top Talent December 6th - 8th, 2023 The Royal Palms Resort & Spa Phoenix, Arizona Please complete your registration by using the link below. LINK{Complete your symposium registration}

Hidden