MAPAN 2008 FALL CONFERENCE
"Building Successful Practices in Perianesthesia Nursing"
Soaring Eagle Casino & Conference Center,
Mount Pleasant, MI
 

Registration Form

Please print, complete and mail along with the registration fee. No online registration accepted.  (Late Registrants please call and confirm)

Name:   ______________________________ Phone: __________________________

Address: _____________________________________________________

___________________________________________________________

Place of employment: _____________________________________________________

RN License Number: ______________________

ASPAN Membership # ____________________

___ RN   ____ CPAN    ____ CAPA    ____ CCRN    _____ OTHER: _______________

Payment:

 MAPAN/ASPAN Member     $100                                                          

 MAPAN Retired Member*     $  45                                                     Mail to:

 Non Members                         $150                                                      Aida Santos

Active Student**                      $  60                                                      1962 Sandlewood

                                                                                        White Lake, MI 48383

*Must be registered as retired with ASPAN                                           

**initial nursing program with school ID

$25 cancellation fee before 9/20/08, No cancellations after 9/27/08

Late Registrations Call:  Aida Santos at (W) 248-465-4316