Spring 2015 Self-Study Forum
Spring 2015 Self-Study Forum
LOCATION
Atlanta, Georgia – April 9-10, 2015
Host Hotel: Atlanta Marriott Buckhead Hotel & Conference Center
SPECIAL SESSION: “The Novice Accreditee” – Making the Most of the Process
REGISTRATION FEE
Please note: Space is limited. Registrations may no longer be accepted once venue is filled to capacity.
Registrations processed after January 26, 2015 for the Chicago Forum and after February 9, 2015 for the Atlanta Forum
- $ 445.00 per participant
- $ 395.00 per participant if 3 or more registrations from the same governing organization or agency.
IMPORTANT INFORMATION:
Payment must be received to confirm registration. Cancellations of confirmed registrations will be charged $150.00 per attendee. Fees are not refundable after February 9, 2015 for the Atlanta Forum. For more detailed information on fees and cancellation policies, please visit . Travel or hotel arrangements should be made after you have received confirmation of your registration from the ACEN office.
REGISTRATION FORM
Are you planning to attend the free Special Session? *
For Attendees of the Atlanta Forum: April 9, 2015 - A Focus on Standard 4 Curriculum
Yes
No
Name of Governing Organization or Agency*
Nursing Education Unit or Department*
Nursing Program Type(s) Offered [Please check all that apply.]*
Clinical Doctorate
Master's/Post-Master's Certificate
Baccalaureate
Associate
Diploma
Practical
Other/Not Applicable
Firstname*
Lastname*
Academic Credentials*
Position/Title*
Address*
City*
State/Province*
Zip Code*
Email*
Phone*
Fax
Method of Payment*
If paying by credit card, please provide your billing address below if different from the nursing program. Credit card payments will be processed by phone upon processing of registration. For questions or assistance with payments, please contact Jocelyn Pineda, Accounting Specialist at .
Check or Money Order
Credit Card
ACEN Voucher Certificate
Purchase Order
Billing Address*
Check if same as above address
Address*
City*
State/Province*
Zip Code*
Comments/Special Instructions
Spring 2015 Self-Study Forum Registration1