Registration KSCLS Spring Conference Kentucky Laboratory Professionals Day:  April 25, 2025“Racing Towards the Future"
Speakers (4 P.A.C.E. Credits*):
Chad Guilliams and Chris Swartz, UK -  Toxicology
Ashley Johnson - Point of Care Testing
David Hamilton - US Public Health Service
Ismail El-Amouri  - Hemostasis

Event Date:  April 25, 2025 (9:00am - 3:00pm), In-Person, Free Parking
Location:  Shelbyville Conference and Welcome Center
219 7th Street, Shelbyville, KY 40065

Students - Please provide SCHOOL email address.
Vendors - Please select "Vendor" under "ASCLS Membership Status and Fee"
Sign in to Google to save your progress. Learn more
Email *
Last Name: *
First Name: *
Professional Employer or School
Lunch Choice: Subway Boxed Lunch
***Register before Friday, April 18, 2025 to reserve your lunch choice.*** 
Please make your lunch selection below. Drinks will be provided at the meeting.

Each box includes your choice of sandwich on Italian bread w/ American cheese, lettuce & tomato (oil, & vinegar, mustard & mayo packets on the side), chips, and a cookie. 2000 calories a day is used for general nutrition advice, but calorie needs vary. Additional nutrition information available upon request. Customization may change calories.

1. Select protein: *
2. Select chips: *
3. Select cookie: *
4. Please add any special instructions for your lunch order. *
ASCLS Membership Status and Fee: *
Select Payment Method *
Check Payments:
Check:  Make payable to "KY Society for Clinical Laboratory Science" and mail to: KSCLS Meeting, c/o Chad Guilliams, 681 Sunny Landing Trail, Lexington, KY  40515 by April 18, 2025.

Venmo QR Code: KSCLS Kentucky State Society @KSCLS (scan from the Venmo App)
PayPal QR Code: KSCLS Kentucky State Society, Chad Guilliams, Treasurer (Scan from the PayPal App)
*Clinical Laboratory Continuing Education events organized by Kentucky Society for Clinical Laboratory Science attendees may earn up to 4 P.A.C.E. approved continuing education hours. "The Kentucky Society for Clinical Laboratory Science (KSCLS) is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. Program."
Registration Policies:
No refunds or vouchers will be issued unless we are notified two business days in advance of the program. An administrative fee will be deducted if a refund is required. Substitutions are encouraged.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Eastern Kentucky University.

Does this form look suspicious? Report