JOIN OUR EMAIL LIST >



 

Fall Educational Workshop in Las Vegas
(
13-14 September, 2010)
At Circus Circus Hotel & Casino in Las Vegas

Click here to pay for your registration via our secure online shopping cart.

Fill out the form below to register & pay via email:

Name:
Email Address:
Facility Name:
Address:
City:
Zip:
Phone:
Fax:
Facility Number:
Member: Yes
No
Additional Materials: Hospice Waiver ($115)
Dementia Care Program ($115)
Resident & Staff Records System ($115)
Medication Training Manual ($115)
Dementia Training Manual ($115)
Staff Training Manual (General Training) ($115)
License Forms Binder (Over 80 Forms) ($50)
Evaluator's Manual (The Blues) ($30)
Title 22 Binder ($30)
Fire & Disaster Manual ($30)
Additional Comments/Questions:
Credit card type: Visa
MC
Discover
American Express
Name On Card:
Credit Card Number:
Expiration: