Area Rep Convention RSVP

Please complete this form to RSVP for the CRONA Convention, held each year on the first Tuesday in October. This form will collect all the information required to complete your registration and ensure that you are correctly paid for your attendance.

"*" indicates required fields

Your personal email address; do NOT use your hospital email address.
RSVP*
Hospital*

Shift and Pay Information

This information will be used to calculate your pay for attending CRONA Convention. You will be paid your hourly rate, without differentials, for the same length of shift you work at the hospital.
What is your shift length?*
Please enter a number from 10.00 to 200.00.
*Please provide your regular rate without differentials.
Max. file size: 256 MB.
We need a copy of a recent pay slip in order to generate your paycheck for attending the Convention. The pay slip must show your name and hourly rate; it is acceptable to black out other areas if desired. YOU WILL NOT BE PAID UNLESS THIS IS COMPLETE. It is acceptable, though not preferred, to email a copy of your pay slip to crona@crona.org.
This field is for validation purposes and should be left unchanged.