All Scholarship winners will be obligated to attend the FASN
Annual Business Meeting and to fulfill any additional assigned duty.

2012 FASN STATE CONFERENCE REGISTRATION

Exciting news!! Registration is again available ONLINE, or by mail!!
SECURE Online Payment is through PayPal™ and may be made with a credit card or bank account.
The ONLY way to make a credit card payment is through PayPal™

Registration is $110 for Members and $140 for Non-Members. All are welcome!

If desired, this registration form can be downloaded and mailed to:

FASN Registration
12606 Chelmsford Ct
Orlando, FL 32837

Please include check or money order, payable to FASN.
Tax ID: 59-3614825.
Credit Card payments may only be made through this online registration form.

Registration includes:
Sessions, Reception, Continental Breakfast, Saturday Lunch, Energy Breaks, Program Materials, CE Credits

mailto:SailorsRN@aol.com

Name
Street Address
City, State, Zip

Home Telephone Work Telephone
 
Fax E-mail Address
 
License Number County
Employer

Please check this box if you are an FASN Member

Please Indicate
School Nurse/Administrator
Credentials
Certified School Nurse

Friday Attendance

Is this your First FASN State Conference? (select one)
No, NOT my First FASN State Conference
YES, This IS my First FASN State Conference

Special Dietary Needs:

There is no separate registration fee for only attending one day.  Fee for registration is as above.

Cancellation Policy: Refund (less a $10.00 processing fee) will be made if cancellation notice is received before January 31, 2012.
Sorry, we cannot refund registration fee after January 31, 2012.

If mailing, send form with check to: FASN Registration, 12606 Chelmsford Ct, Orlando, FL 32837
Registration fee must be received prior to February 3 or on site fee will be charged.

Following a successful registration, you will be issued a password to download available Conference handouts here.
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