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Nursing Annual Research Conference
Online Registration Form

(* required fields)
Registrant Information
Name:* (Full Name)  
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City:*
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Zip:*  
Daytime Phone:*    
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Nursing Continuing Education Credit Requested?  
Prefer written confirmation:
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I Plan to Attend
All breakdown sessions presentations will be repeated after the lunch. Please indicate your first and second choice for each session. Session assignnments will be made on a "first come first served" basis.
Choice 1 Choice 2  
Morning Afternoon Morning Afternoon













  • Childhood Obesity - Nutrition


  • CATCH Pediatric Mobile Team


  • The Sports Pre-Participation Physical Evaluation


  • Tansition from Pediatrics to Adult Medicine
     
    Before 8/28/09 After 8/28/09


$ 75

$ 35

$ 100

$ 50

Method of Payment
Total Amount:  $
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Exp Month: (mm)  
Exp Year: (yyyy)  
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Registration fee for scientific session includes continental breakfast, lunch, breaks and all course materials. A $25 service fee will be charged for refunds requested in writing, postmarked on or before September 12, 2009. No refunds will be made after September 12; however, substitutions will be accepted.
 
Handout materials, break refreshments or lunch will not be available without preregistration.


Questions? Contact Delphine White at dwhite@dmc.org or (313)745-5458.



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