Partnered with:
/ Registration Form
Proactive IDT Documentation
Train the Trainers
Intensive Training Workshop
2Day Training
January 20, 2011 8:30am – 5:30pm
January 21, 8:30am – 4:30pm
Location: TX & NM Hospice Organization’s Building
1108 Lavaca, Austin, TX 78701

Each attendee must complete a separate registration form. This form is for attendees paying with check only. If you would like to pay with credit card go to:

 Single attendee  Additional attendees same organization

Name of Participant: ______Credentials: ______

Title: ______Organization: ______

Address: ______

City: ______State: ______Zip: ______

Phone: ______Fax: ______

Email: ______

Total Registration Fees:

 $349. Per attendee

Payment in full must be received to reserve your space in the training session.

 Check (Use the on-line form to make credit card payments:

Cancellation/Refund Policy:

The Sponsors reserve the right to cancel the program for insufficient registration. In case of sponsor cancellation, pre-registered participants will be notified and a full refund provided. Participant requests for cancellations/refunds must be received in writing by January 1, 2011. After that date a 20% processing fee will be charged for all cancellations

Mail Registration(with payment):

TX & NM Hospice Organization, PO Box 1525, Austin, TX 78767

Thank you for registering for our Proactive IDT in Austin. We'll see you on January 20th & 21st

Our address is 1108 Lavaca, Austin, TX 78701 (7th Floor). Bring a jacket because it gets cold in the meeting room. Parking is free at our building, please park in spaces 6-106. Look for the Hospice Sidewalk sign in between 11th and 12th street on the left hand side for our parking garage and access to the building.

If you have any questions or comments please email us at Or Call 512.454.1247

Accommodations

We recommend trying to find reduced rates on travel websites such as:

Reduced rates have been negotiated with these hotels:

DoubleTree Hotel -- $119 based on availability (5 miles from our building):

6505 North I-35

Austin, TX 78752

(866) 660-7005

Ask for the corporate rate for Texas and New Mexico Hospice Organization or 0560073287

Note: this is about 5 miles away from our offices Get directions

Book on-line:

Hilton Garden Inn Austin Downtown ( 15 blocks from our building)

500 N IH 35, Austin, TX 78701

512-480-8181

Rate is $139/night – ask for corporate rate N2685843

Note that this is fifteen blocks from the Texas Hospital Association Building.

Directions to the hotel:Located on the west side of I-35, on the access road, between 5th and 6th streets.

Taxi or Super Shuttle is available from Austin Bergstrom International Airport.

The Mansion at Judges Hill (8 blocks from our building)

1900 Rio Grande, Austin, TX 78705

Weeknight rate: $159/night (Ask for Texas and New Mexico Hospice Rate

1-800-311-1619

Directions to the hotel: From IH-35:Take the MLK Blvd exit (Exit 235A).

Coming from the north (Dallas), turn right at the first stoplight onto MLK.Coming from the south (San Antonio), turn left at the second stoplight onto MLK. Follow MLK for 0.8 mile.The Mansion will be on the right at the corner of MLK & Rio Grande.Go through the light at Rio Grande & take an immediate right into the driveway.

Doubletree Guest Suites – Downtown Austin (2 blocks from our building)

303 W 15th St, Austin, TX 78701

512-478-7000

Rate is $169/night – ask for corporate rate 0560052112 ask for the “Wells Fargo Rate”

The Doubletree is two blocks from the Texas Hospital Association Building.

Directions to the hotel: From I-35, exit onto 15th St and drive west towards the Capital.The hotel is 7 blocks down, on the left at the corner of 15th and Guadalupe.

Taxi or Super Shuttle is available from Austin Bergstrom International Airport.

Omni Hotel Downtown (8 Blocks from our building)

Rate is $159/night

700 San Jacinto Blvd

Austin, TX 78701

512-476-3700 or

1-888-444-OMNI (6664)