2010 FASN STATE CONFERENCE REGISTRATION
Deadline for Registration is January 31, 2010 

SECURE Online Payment is through PayPal™ and may be made with a credit card or bank account.

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, Contact hours

Direct Registration Process or FASN Conference questions to Janie Sailors at Past-President@FASN.net

Name
Street Address
City, State, Zip

Home Telephone Work Telephone
 
Fax E-mail Address
 
License Number County
Employer
Please Indicate your credentials:
FASN Member
School Nurse
School Administrator
RN
LPN
Certified School Nurse

Yes, I will be attending the Friday, February 5, 2010 Workshop Sessions.

 

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, 2010.
Sorry, we cannot refund registration fee after January 31, 2010.

If mailing, send form with check to: FASN Registration, 12606 Chelmsford Ct, Orlando, FL 32837
Registration fee must be received prior to February 5 or on site fee will be charged.
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