Dallas AORN Seminar - Registration Form

P R I N T

T H I S

P A G E

REGISTRATION FORM

GIRL TALK: Issues in Women's Health
February 27, 2010

Methodist Hospital ~ Hitt Auditorium
Colorado Avenue at Bishop ~ Dallas, TX 75208

Instructions:
1) Complete the form ~ 2) Make check payable to DALLAS AORN ~ 3)Mail form and check to

Terri Goodman, DallasAORN Treasurer
PO Box 29133
Dallas, TX 75229

Name (with credentials)

Address

City / State / Zip

Preferred Phone
(Indicate DAY or EVENING)

E-mail Address
(For registration confirmation)

Facility

REGISTRATION DEADLINE: February 19, 2010
$75.00 FOR ALL REGISTRATIONS POSTMARKED AFTER February 19, 2010
NO REFUND FOR CANCELLATION AFTER February 19, 2010


		$50.00	AORN memberAORN ID #_______________
		$65.00	General Admission
		$30.00	Students (this does not apply to nurses who are back in school)
		$75.00	Late registration Postmarked after February 19, 2010 - applies to everyone