2015 WVSHE Annual Conference August 18, 19, 20 & 21, 2015 Canaan Valley Resort, Davis, WV AGENDA Tuesday, August 18th: TBD 12 Noon – 1:00 p.m.: Registration & Round Table Discussion 1:00 p.m. – 3:00 p.m.: TBD 3:00 p.m. – 5:00 p.m.: TBD 5:00 p.m. – 9:00 p.m.: Late Registration and Trade Show set-up

West Virginia Society for Healthcare Engineering Annual Meeting Educational Agenda Wednesday, August 19th: TBD 6:30 a.m. – 7:45 a.m.: Vendor Late Registration and Trade Show setup 7:00 a.m. – 7:45 a.m.: Member Late Registration and Breakfast (Included with registration) 8:00 a.m. – 9:30 a.m.: WVSHE Business Meeting 9:30 a.m. – 10:00 a.m.: Break and Set Up of Trade Show 10:00 a.m. – 1:30 p.m.: TRADE SHOW and Lunch at Noon (Included with registration) 1:30 p.m. – 2:00 p.m.: Break and Tear Down of Trade Show 2:00 p.m. – 5:00 p.m.: TBD 6:00 p.m.: DINNER – Open to all family members/associates (Included with registration) NOTE: Thursday and Friday events do not apply to Vendors unless paying for Educational Conference Registration in addition to the Trade Show Registration.

West Virginia Society for Healthcare Engineering Annual Meeting Educational Agenda Thursday, August 20th: TBD 7:00 a.m. – 7:30 a.m.: Breakfast (Included with education registration) 7:30 a.m. – 9:30 a.m.: TBD 9:30 a.m. – 9:45 a.m.: Break 9:45 a.m. – 11:45 a.m.: TBD 11:45 a.m. – 1:00 p.m.: Lunch (Included with education registration) 1:00 p.m. – 2:00 p.m.: TBD 2:00 p.m. – 2:15 p.m.: Break 2:15 p.m. – 5:15 p.m.: TBD

West Virginia Society for Healthcare Engineering Annual Meeting Educational Agenda Friday, August 21st: TBD 7:30 a.m. – 8:00 a.m.: Breakfast (Included with education registration) 8:00 a.m. – 10:00 a.m.: WV State Fire Marshal – Code Update 10:00 a.m. – 10:30 a.m.: Break and check out of room. 10:30 a.m. – 12 noon.: Office of Health Facility Licensure and Certification Updates Presented by _______ with OFLAC 12 noon: Conference ends; Lunch on your own.

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Education Meeting Registration Form Page 1 of 2 Conference Education Registration: Please complete the registration form below and mail it along with your check payable to WVSHE to: WVSHE C/O Timothy Lee, Secretary/Treasurer 1239 Frozen Camp Creek Rd. Gay, WV 25244 Work # (304) 766-3684 Email: timothy.lee@thomaswv.org Please register by 7/1/15 so we can plan our meals. Late Registrations $25.00 extra fee MEMBERS NON-MEMBERS 0 – 100 beds - $100/person 0 – 100 beds - $200/person 100 + beds - $150/person 100 + beds - $250/person ASSOCIATE Sponsors (Attending Education Sessions) - $100/person NONASSOCIATE Sponsors (Attending Education Sessions) - $200/person Name: _____________________________________________________________________ Company: ___________________________________________________________________ Address: ____________________________________________________________________ City, State, and Zip Code: _________________________________ ____ ________________ Phone: _______________________________ Fax: _________________________________ E-Mail: _____________________________________________________________________ Number of beds in your facility: _____________ Amount Enclosed: ____________________ ____ WVSHE Member _____WVSHE Associate Sponsor ______ I am not an ASHE member ____ I was an ASHE member in 2013-2014 ____ I am an ASHE member for 2015 ASHE Membership # _____________

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Education Meeting Registration Form Page 2 of 2 Dear WVSHE Annual Meeting Participant, As most of you know, the WVSHE annual meeting is a family event. Each year after the Wednesday Dinner and Entertainment, a gift is presented to each of the children in attendance. The WVSHE provides the funding for these gifts. In order to help purchase the appropriate items, please complete this form and return it with your registration. We do not want to forget our vendor’s family’s children attending the event so if you would also complete this form and return with your registration. Thank you for your cooperation. Number of Boys ___________ or Girls _______________ Ages 0-2 Number of Boys ___________ or Girls _______________ Ages 3-5 Number of Boys ___________ or Girls _______________ Ages 6-9 Number of Boys ___________ or Girls _______________ Ages 10-12 Number of Boys ___________ or Girls _______________ Ages 13-18 Your Name: ______________________________________________ Your Company Name: _____________________________________

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Trade Show Registration Form Page 1 of 2 Please register by July 1, 2015, so we can plan our meals. The West Virginia Society for Healthcare Engineering annual meeting will be held on August 18th – 21st at Canaan Valley Resort. On Wednesday August 19, 2013, the trade show will be held from 10:00am to 1:30 pm. To complete the day, the annual evening event and dinner will be held. If your company would like to educate the WVSHE members on new technologies and the latest healthcare products, please complete the registration forms below and return it to the secretary/treasurer along with your check made payable to WVSHE by July 1, 2015. If you have any questions or need additional information, please e-mail Timothy Lee : timothy.lee@thomaswv.org or call (304) 766-3684. WVSHE C/O Timothy Lee 1239 Frozen Camp Creek Rd. Gay, WV 25244 Cost is $300.00 per table with a $20.00 discount for each additional table. Late Registrations $35.00 extra fee Vendors can set up Tuesday Evening between 5:00p and 9:00p or Wednesday morning before 8:00a. Vendors are eligible for the same room rates as WVSHE members. Company Name and Website:________________________________________________ Your Name: ______________________________________________________________ Company Contact Person:___________________________________________________ Street Address:____________________________________________________________ City, State, Zip:____________________________________________________________ Telephone :______________Fax: ___________E-mail:____________________________ Number of table’s requested:_________________________________________________ Amount enclosed :_______________________________Make checks payable to WVSHE WVSHE Associate Sponsor: Yes________ No_______ *Donated door prizes will be given away to register participating WVSHE members during the trade show.

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Trade Show Registration Form Page 2 of 2 If you are shipping items to the event please use the following information: Your Name or Your Company Name c/o Location????? Canaan Valley Resort 230 Main Lodge Road Davis, WV 26260 WOULD YOUR COMPANY LIKE TO ADVERTISE ON THE WVSHE WEBSITE? Vendors may purchase yearly subscriptions for ad space on the WVSHE website. Standard rate for non-members is $450.00 and the discounted rate for associate members is $300.00 Your ad includes: Logo of your company Phone#, Fax#, and E-mail for each paid Associate Member or Main Phone, Fax, and E-mail of company if not an Associate Member Link to your home web page if provided You will be required to provide this information in an e-mail in a form that will allow editing and resizing. Terms: Ad subscription payments for one year are due in advance. Ad subscriptions are NOT automatically renewed at the end of year. To simplify accounting, all ad space subscriptions have the same start and ending dates of August 1st to July 31st. Any changes must be sent via email. Allow at least 4 weeks for modifications. Non-payment of ad space will result in removal from site. WVSHE will make reasonable attempts to contact vendor prior to removal. For more information, see our website at www.wvshe.org or contact Timothy Lee at timothy.lee@thomaswv.org.

WVSHE DUES fiscal year runs from June 1 through May 31. WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Membership / Sponsorship Registration Form Page 1 of 2 WVSHE DUES fiscal year runs from June 1 through May 31. Individuals eligible for membership in the association shall be those actively employed in the field of healthcare engineering and/or maintenance department as designated by the department head or administrator of member institutions. Individual membership / sponsorship classifications shall be as follows: (a) Active (voting) member – any individual eligible to hold office as defined above. (b) Associate Sponsor (non-voting) – representative of suppliers, contractors, consulting engineers, and other groups that have a technical knowledge, resource material and a direct interest in the healthcare engineering field may apply for membership as associate. This member will have no voting rights and shall not hold elective office. (c) Honorary NO Charge (non-voting) member – Former member who has retired from their healthcare related position. This member will have no voting rights and shall not hold elective office. Please fill-in information below and ENCLOSE CHECK PAYABLE TO WVSHE FOR $35.00 Name you want on certificate of attendance forms. ________________________________________ Name you go by: ___________________________________________________________________ Active Member:_____________, Retired Member___________or Associate Sponsor:____________ Company Name:_____________________________Website: _______________________________ Title:_____________________________________________________________________________ Work Address: Street/PO Box:________________________________________________________ City:_____________________________________ State:____________ Zip: __________________ Work Phone # _____________________ Ext. # ______ Cell Phone # _______________________ Work Fax # _________________ Work Email: __________________________________________

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Membership / Sponsorship Registration Form Page 2 of 2 Home Address: Street/PO Box:______________________________________________ City:____________________________________State:______________ Zip: ________ Home Phone # ______________ Home Email: _________________________________ Send invoice to: Home Address_____ or Work Address______ Are you a member of ASHE? Yes ___ or No ____ If yes ASHE Membership # _______ Were you a member of ASHE Last Year? Yes_______ No_______ If Healthcare application, number of beds in your facility __________ Return to: WVSHE C/O Timothy Lee, Secretary/Treasurer 1239 Frozen Camp Creek Rd. Gay, WV 25244 Work # (304) 766-3684 Email: timothy.lee@thomaswv.org

WEST VIRGINIA SOCIETY FOR HEALTHCARE ENGINEERING 2015 Annual Meeting Hotel Reservation Information This year’s annual meeting will be held at Canaan Valley Resort from August 18-21. Please reserve your room on or by June 16, 2015 as this is the last day the special discount rates will apply. Registrations made after this date may not be guaranteed and may have higher rates. To reserve your room, please contact Canaan Valley Resort directly at 800-622-4121 and select Option 1. Use Group # 15757 when making your registration to obtain the discounted rates. If you need an early check-in, please make your request when you make your reservation. Room rates are as follows: 2 Queens or 1 King $119/night Junior Suite $135/night King Suite $250/night REMINDER: There are no activities included with the rooms. Activities requiring payment will either be charged to your room, or on a pay as you go basis. For room descriptions, available activity lists, driving directions, etc., please visit the Canaan Valley Resort website at http://canaanresort.com/13/