9th Annual NEI Registration


First Name:    Last Name:    County: 

Mailing Address:    City:    State: 

Zip Code:    Phone Number:    E-Mail Address: 



Employer:    Address: 

City:    State:    Zip: 


    Cancellation Policy:  An administrative fee of $75.00 will be charged for changes to registrations prior to March 15, 2009.   After March 15, no refunds will be issued.

  Will be attending the opening reception            Will be bringing a guest

Pre-Conference Sessions   NLN CNE Preparation Course  .....  $250 (member)
  NLN CNE Preparation Course  .....  $350 (non-member)
  E-Learning Techniques  .....  $99
  Integrating Simulation  .....  $99
You must call to register for integrating simulation
Breakout Sessions 1:45 to 3:00
A      B 		Sessions 3:05 to 4:20
C      D
Early-bird
Registered before Feb. 1		   Registration Fee  .....  $475
  Group Discount (3 or more)  .....  $450 per attendee
  Large Group Rate (6 or more)  .....  $375 per attendee
Regular
Registered after Feb. 1		   Registration Fee  .....  $525
  Group Discount (3 or more)  .....  $500 per attendee
  Large Group Rate (6 or more)  .....  $425 per attendee
Any one-day fee   One Day Only  .....  $150 per attendee
  Student Fee  .....  $75 per attendee

  Tuesday            Wednesday            Thursday (Barb)            Friday

Requests:            I Request a Vegetarian Lunch            I Request a Registration Receipt

This form does not total your fees, please be sure of what you checked.
If we spot an error, we will contact you at the phone number you provided above.

I authorize use of my credit/debit card: VISA Mastercard

Card Number: A value is required. 3-Digit V-Code*: A value is required.Exp. Date: A value is required.Invalid format.

Since it's hard to sign a web page, please indicate the month of your birthdate: Please select an item.Please select an item.

 



*(the 3 digit v-code is that silly little number on the back of your card)