NHPCO Meetings & Education 2010 - (Page 25)
Developing the Care Continuum:
Innovative Models to Meet the Unique Needs of Patients/Families Conference
Hospice Manager Development Program August 3-4 • NASW Annual Practice Conference August 3-4 • NHPCO Main Conference August 5-7
2010 NHPCO and NASW Registration Form
(Please type or print clearly. Use a separate form for each registrant; copy as needed.)
Side 1
Attendee Name ________________________________________________________________________ Credentials (RN, LCSW, etc.) ______________________ Organization __________________________________________________________________________ NHPCO or NASW Member # ________________________ Address ____________________________________________________________City ______________________________State____________ Zip ________________ Phone ______________________________________Fax ____________________________________ Email Address
____________________________
❑
First-time Attendee
❑
I require special services to fully participate in the conference (please attach a description of your needs)
To register for the NASW Annual Practice Conference on August 3-4,
make your selections in the boxes below. Advance prices valid until July 16, 2010. Participants can earn up
to 8.5 contact hours of continuing education credit for social workers (included in registration fee).
Advance (until 7/16/10) Onsite (after 7/16/10)
NHPCO/NASW Member Non-Member NHPCO/NASW Member Non-Member
SUBTOTAL
NASW’s Annual Practice Conference August 4 (Select one session per time slot)
1:00 pm-2:30 pm 2:45 pm-4:15pm
❑ Ethics-Part I * ❑ End-of-Life Care in Nursing Homes ❑ Family Crisis Counseling and Disasters ❑ Hospice vs. Palliative Care: Is There Really a Difference? ❑ Ethics-Part II * ❑ Self-Care ❑ Transformative Nature of Bereavement and Grief ❑ Cultural Competency in End-of-Life Care
Subtotal
Advance (until 7/16/10)
Onsite (after 7/16/10)
❑ $225
❑ $275
❑ $275
❑ $325
*MUST attend both sessions.
$
To register for the Hospice MDP and NHPCO Conference,
make your selections in the boxes below. Advance prices valid until July 16, 2010.
NHPCO/NASW Member Non-Member NHPCO/NASW Member Non-Member
SUBTOTAL
Hospice Manager Development Program Foundational Course August 3-4 PACE Site Tours August 4 • 10:00 am-1:00 pm (Limited to 20 attendees) Main Conference (DCC10) August 5-7 Day Passes/Member Day Passes/Non-Member
For CE/CME info visit: www.nhpco.org/continuingeducation
❑ August 5 - $199 ❑ August 6 - $199 ❑ August 7 - $99 ❑ August 5 - $225 ❑ August 6 - $225 ❑ August 7 - $150 Guest Passes (does NOT include educational sessions) ❑ August 5, 6 and 7 - $165 Guest Name: a FREE ❑ Complimentary Boxed Lunch August 5 NHPCO cannot guaranteeto free lunch unless you check the box pre-register! MDP and NHPCO Main Conference CE/CME ❑ Nurse $40 ❑ Social Worker $40 ❑ Physician $40 ❑ Counselor $40
❑ $395 ❑ $40 ❑ $475
❑ $595 ❑ $40 ❑ $575
❑ $470 ❑ $40 ❑ $575
❑ $670 ❑ $40 ❑ $675
Subtotal
$
NHPCO Main Conference registrants using the Team Registration Discount — please use “Side 2” for payment.
Payment Information
TOTAL payment for this attendee*
$
❑
Card Number
❑
❑
❑ Check enclosed, payable to “NHPCO”
Exp. Date
*If payment in full does not accompany this form, your registration will not be processed.
◆ Checks not in U.S. funds will be returned. ◆ A charge of $25 will apply to checks returned for insufficient funds. ◆ In the event the total calculated is incorrect, NHPCO will charge the remaining amount deemed to be accurate and appropriate.
Registration Cancellation Policy – All cancellation requests must be made in writing. A $50 processing fee will apply to all cancellations. Cancellations made on or before June 18, 2010, will receive full refund less the $50 processing fee. Cancellations made between June 19 and July 16 will receive 50% refund less the processing fee. No refunds will be given on registration cancellations postmarked after July 16, 2010. Cancellation requests or substitution requests can be sent via email to conferences@nhpco.org or via fax at 703/837-1233 or 877/779-6472. NHPCO reserves the right to substitute faculty or to cancel or reschedule sessions due to low enrollment or other unforeseen circumstances. If the conference must be cancelled, registrants will receive full credit or a refund of paid registration fees. No refunds can be made for lodging, airfare, or any other expenses related to attending the conference.
FOR YOUR SECURITY: Cvv2 Code is Now Required for All Credit Card Transactions
Visa and MasterCard The 3-digit Cvv number is on the back after and to the right of your card number. American Express The 4-digit Cvv number is printed on the front right hand side of your card.
4-Digit (AmEx only)
Cardholder/Authorized Signature** ______________________________________________
HOW TO REGISTER
ONLINE:
MAIL:
www.nhpco.org/dcc10
FAX:
877/779-6472 (toll-free)
DCC10 Conference Registration NHPCO P.O. Box 34929 Alexandria, VA 22334-0929
25
http://www.nhpco.org/continuingeducation
http://www.nhpco.org/continuingeducation
http://www.nhpco.org/dcc10
http://www.nhpco.org/dcc10
Table of Contents for the Digital Edition of NHPCO Meetings & Education 2010
NHPCO Meetings & Education 2010
Table of Contents
Conference Overview
Who Will Attend
Who Should Attend
Conference Objectives
Travel Discounts
Hotel Parking
The Westin Boston Waterfront Hotel
Car Rental
Welcome to Boston
Conference Logistics
Ground Transportation
Conference Highlights
Conference Registration Hours
NHPCO’s Marketplace
General Information
Welcome Reception with the Exhibitors
Cyber Station/Handouts
Complimentary Boxed Lunch
PACE Site Tours
Education Highlights
NASW Conference
Counselors
Continuing Education
Nurses
Physicians
Social Workers
NHPCO’s Hospice Manager Development Program
Plenary Sessions
Concurrent Sessions
Agenda-At-A-Glance
General Registration Information
Registration Form
NHPCO’s 11th Clinical Team Conference Early Bird Sneak Peek
Future NHPCO Conference Dates and Locations
NHPCO Meetings & Education 2010
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