2024 Conference Registration

Get help now

MASMHC / NSMHC Registration

Reception Registration

We hope you’ll join us for networking following the Middle America School Mental Health Conference on May 29 and 30! Reception tickets are an additional cost to your conference registration and must be purchased separately. Ticket price includes heavy appetizers and two drink tickets.

Day 1 reception (May 29): $30/person
Day 2 reception (May 30): $30/person
Both Day 1 and Day 2 reception (May 29-30): $50/person

* indicates required fields

Please select which conference(s) you are registering for:*

Middle America School Mental Health Conference (May 29-30, 2024)

Nebraska School Mental Health Conference (May 31, 2024)

Both the MASMHC and NSMHC (May 29-31, 2024)

How many tickets would you like to purchase?*

Middle America School Mental Health Conference Fee – 2024

How many tickets would you like to purchase?*

Nebraska School Mental Health Conference Fee – 2024

How many tickets would you like to purchase?*

Combined MASMHC and NSMHC Fee – 2024

Total

Ticket 1

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

e.g. nurse, psychologist, licensed mental health provider, counselor, social worker, educator, administrator

Attendee Credentials*

e.g. APRN, BSN, RN, LMHP, MSW, PhD, MA, BA

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 2

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 3

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 4

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Credentials*

Attendee Title*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 5

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 6

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 7

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 8

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 9

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Ticket 10

Attendee Name*

First Last

Attendee Email*

Attendee Organization*

Attendee Title*

Attendee Credentials*

Attendee Address*

Street Address City State ZIP Code

Attendee Phone*

Dietary Restrictions

If you have special dietary requests, please list them here or contact Sidney Howard at showard@thekimfoundation.org or 402-891-6998.

Billing Information

Contact Name*

First Last

Contact Email*

Subscribe to The Kim Foundation monthly newsletter for the latest updates on future conference events and activities.

Yes

Contact Phone Number*

Billing Address*

Street Address City State ZIP Code

Total

Credit Card*

Card Details

Cardholder Name

CAPTCHA