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Use the Form Below for Registration

INFORMATION ABOUT YOU
* Indicates required fields
* First Name: * Last Name: Credentials:
* Badge Name: Create a User Name and Password for accessing the online Evaluations and your CE Certificate.
* Username:  *Password: 
* Age:
* Gender:
* Race:
* Discipline:
* Workplace Type:
* Work/Organization
* Work Address:
* City:
* State/Province: * Zip Code: *Country:
* Work Phone:
*Work E-Mail
* Home Address:
* City:
* State/Province: * Zip Code: *Country:
* Home Phone:
*Personal E-Mail
Please check if you are the contact/primary presenter for a concurrent session. (Sorry, this does NOT include poster presenters.)
Please check if you are a Conference Monitor.
Please check if you are a University of Northern Colorado Nursing PhD student.
 
MAIN CONFERENCE REGISTRATION OPTIONS
(Please choose one option)
Main Conference: July 21st, 22nd, and 23rd, 2011
Does not include Pre-Sessions $475 on/before June 20; $505 after June 20
Primary Presenter Discounted price ($25 Discount - only 1 per session, please) $450 on/before June 20; $480 after June 20
Conference Monitor Discounted Price ($25 Discount) $450 on/before June 20; $480 after June 20
University of Northern Colorado Nursing PhD Student Discounted Price $240 on/before June 20; $270 after June 20
1/2 Day only - THURSDAY, JULY 21st $175 on/before June 20; $210 after June 20
Full Day FRIDAY ONLY, JULY 22ND $310 on/before June 20; $340 after June 20
Pre-Session 1 Only $149 on/before June 20; $179 after June 20
Pre-Session 2 Only $149 on/before June 20; $179 after June 20
Pre-Session 3 Only $149 on/before June 20; $179 after June 20
 
PRE-SESSION REGISTRATION OPTIONS
(You may choose more than one)
Pre-Session 1 - Wednesday-PM, July 20th, 2011 $149 on/before June 20; $179 after June 20
Pre-Session 2 - Thursday-AM, July 21st, 2011 $149 on/before June 20; $179 after June 20
Pre-Session 3: Thursday-AM, July 21st, 2011 $149 on/before June 20; $179 after June 20
CONCURRENT SESSIONS
(See brochure for description of each session)
Thursday - Session 4: 3:00-4:00 PM
T4 T5 T6 T8 None Requested
Sorry T7 has been CANCELLED! 		 
Friday - Session 5: 9:30-10:30 AM
F9 F10 F11 F12 F13 F14 None Requested 		 
Friday - Session 6: 11:00 AM to Noon
F15 F16 F17 F18 F19 F20 F21 None Requested 		 
Friday - Session 7: 2:00 - 3:00 PM
F22 F23 F24 F25 F26 F27 None Requested 		 
Friday - Session 8: 3:30 - 4:30 PM
F28 F29 F30 F31 F32 F33 None Requested 		 
Saturday - Session 9: 7:30-8:30 AM
S33 S34 S35 S36 S37 None Requested 		 
Saturday - Session 10: 9:00-10:00 AM
S38 S39 S40 S41 S42 None Requested 		 

OPTIONS

Friday Evening Dinner Session with Dr. Paulette Rollant
Three Course Dinner with Five-Star Starters (2 CEUs)
I will be attending this event. $50.00 (fee)

Additional Guest Tickets for Welcome Reception and Poster Presentations
Number of Guests I will be bringing: . $35.00 (per guest).

Please use the submit button to enter the above information. You will then be directed to a page to enter your payment information.

Note! Requires Knowledge of the Credit Card Billing Address. Supplying the wrong address information on a credit card will cause payment failure.

IF NOT REGISTERING ONLINE ADD $50.00 TO REGISTRATION FEE

  1. REFUND POLICY: Fee refunded, less a $50.00 handling charge, if canceled by the early deadline of June 20, 2011. No refunds after early registration deadline. Centennial AHEC reserves the right to cancel this conference and/or pre-sessions due to inadequate registration or unforeseen circumstances. All registered persons will be notified if cancellation occurs.
  2. A link to our privacy policy – http://www.cahec.org/pdf/CAHEC_Privacy_Policy.pdf

    Registration Problems

    If you have any problems with the registration process please e-mail:
    tdarrington@cahec.org