Register Online

About the Registrant

	All fields with an asterisk are required.
*First Name:
*Last Name:
Organization:
*Street Address:
*City:
*State:
*Zip:
*Daytime Phone:
Daytime Fax:
*Email:
Emergency Phone:	Used to notify you if conference is cancelled.
	Please indicate you PRIMARY job responsibility:
	*Please indicate whether you would like your contact information included in the attendee roster: Yes No
There have been requests for contact information of conference attendees. We will provide a roster of participants to all conference attendees, which includes: Name, Address and Phone Numbers. (Only those marked NO will be excluded. If this section is UNMARKED, that person's information WILL be included.)

Conference Selections

Please ENTER THE NUMBER OF THE SESSION you want to attend FOR EACH TIME FRAME. This information is helpful in making room assignments and avoiding crowding in the sessions.
Thursday, December 03, 2009: Pre-conference
	1:00-4:30 p.m. (Sessions 1-5)
Friday, December 04, 2009: Main Conference
	10:15-11:30 a.m. (Sessions 6-11)
	2:00-3:15 p.m. (Session 12-17)
	3:30-4:45 p.m. (Session 18-23)
Saturday, : Main Conference
	General Session 8:30-11:20 a.m.	Yes No (please indicate if attending)

I require:	vegetarian meal special meal
	(please describe)
	Special arrangements for facilities (please describe)

Fees:
NO PURCHASE ORDERS ACCEPTED!

Pre-Conference:	Yes No $50.00
Conference:	Regular $140.00 Student (Full Time) $50.00 (Must be enrolled 12 hours and offer proof of school registration at conference.) Attending Pre-conference Only
Nursing CEU's	Yes No $25.00
Payment Options:
IMPORTANT: Please review your conference selections before you press the Submit button. Once submitted, you will not be able to edit your conference information.