NBNA Conference 2009 Toronto Online Registration

Use the form below to complete Step 1 of your online registration. After submitting your information you will be sent to Step 2 for online payment.

To Fax or Mail your form click here to download the registration form.


1. Registration Information (Exhibitors and Sponsors DO NOT use this form)

....One registration per form.

 
First Name
 
Last Name
 
Credentials (required*)
 
Address
 
City
 
State
 
Zip
 
Home Phone
 
Work Phone
 
Fax
 
Email
 
Current NBNA Member
    If not would you like to become a member? If yes, click here.
 
NBNA ID#
 
RN/LPN/LVN License No.
 
Social Security #
 
I am a Direct Member (do not belong to a chapter)
 
Name of Chapter (required*)
 
Emergency Contact
 
Phone
 
Do You Require Vegetarian Meals?

Institute Registration
Continuing Education Units will be awarded at the 36th Annual Institute and Conference. To receive the full compliment of continuing education units, you MUST attend the Institute and/or Workshop of your choice IN ITS ENTIRETY. The Institutes will be held on Wednesday, August 4, 2009. Please choose one of the following (click on the drop down box):
VITAS: Train the Trainer 2-Day Session Sun, Aug. 2, 8:00 am-5:00 pm & Wed, Aug. 5, 8:00 am-12:00 pm (Pre-registration required)
Presidents' Leadership Workshop (for chapter Presidents and Vice Presidents ONLY-Sunday August 2, 2009)
I am a new NBNA member
This is my first NBNA Conference
I plan to go on the Local Chapter Sponsored Tours
I would like to volunteer for conference registration or workshop monitor

Guest Registration*
NON-Nurse Guest(s) Registration (Adults or Children) $150.00 Each: *Registration Includes: Sessions Open to the Public, Exhibit Area President's Reception and Banquet, and Sunday Brunch.
  Please check here if Guest(s) require vegetarian meals
 
Non-Nurse Adults
   
  Address: (If different from registrant's)
  Children Age
    Age

FINISH YOUR REGISTRATION CLICK SUBMIT BUTTON:

MEMBER

Pre-Conf 4/1-6/15/09

RN/LPN/LVN...... $325
Student (NON-Licensed)...... $205
Retired.... $250

On Site After 6/15/09
RN/LPN/LVN...... $450
Student (NON-Licensed)...... $330
Retired.... $375

 

GUEST(S)
Adults or Children....$150 each

NON-MEMBER

Pre-Conf 4/1-6/15/09
RN/LPN/LVN...... $500
Student (NON-Licensed)...... $280
Retired.... $345

On Site After 6/15/09
RN/LPN/LVN...... $650
Student (NON-Licensed)...... $430
Retired.... $425


Additional Banquet or Brunch Tickets

Institute of Excellence Luncheon....$75 per ticket
President's Banquet & Gala ....$80 per ticket
Brunch & Closing Session....$50 per ticket