Dietary Support Services serving the USA, located in the Tampa Bay Area, Led by Gail Yip-Chuck

additional topics:

Online Registration

Registration-print and fax or mail

1st Annual Food Safety Symposium on Healthcare

Embassy Suites Hotel - Busch Gardens, Tampa, FL

Presenters Gail Yip-Chuck and Alan M Tart from FDA

Please click on the down arrow to choose the city and date



registration tuition Other
early registration ends 3-1-2010	$125
regular registration begins 3-2-2010	$135
late registration within 24 hours of program	$145
Not Applicable:	N/A
optional food safety resources
food protection certification exam	$75
food safety online training for employees	$15
food safety online training for managers	$60
Not Applicable:	N/A

attendee information

All Items marked with an * are required or the form will not be accepted.

If you are registering for more than one person and paying with the same Credit Card, please add the additional names in the Comments area below.

Name 1:
Name 2:
Name 3:
Address*:
City*:	State*:	Zip*:
Day Phone*: Fax:
E-Mail Address:

Please include a fax number or email address to receive your registration confirmation.

payment method

credit card payment information

All information is required or the form will not be accepted.

Note: We do NOT accept AMEX or Discover


Card Holder's Name*:
Billing Address*:
City: State: Zip*:
Credit Card Type:	Visa	MasterCard
Credit Card Number*: XXXX-XXXX-XXXX-XXXX
Exp Date (MM/YY)*:
Last 3 or 4 Digits on back of Card*:		Example: