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October 7, 2008 - Charleston, West Virginia
This workshop is open to all who are interested. Please complete the registration form below to register for the meeting. The deadline for registration is 5:00 p.m. on or before September 29, 2008. All registrations received after the deadline will incur a $10 fee (total attendance cost of $70). Attendance costs are non-refundable after the registration deadline, however a substitute may be sent in your place if you are unable to attend. All registered persons are responsible for payment even if you do not attend the meeting.
Registration Information
Name:
Job Title :
Facility Name :
Facility Address :
City :
State:
Zip Code :
Phone :
Fax :
Email:
How would you like to receive your registration confirmation? Fax Email
I will need continuing education credit for: Nurses Technicians Dietitians Social Workers
Do you have certification for your discipline? Yes No
If yes, please select one:: CNN CDN CCHT LCSW Other (please indicate: )
