Upcoming educational events for California Association of Healthcare Quality Members

The 2009 Healthcare Quality Overview and Certification Workshop Online Registration Form

Name:
Title:
Organization::
Mailing Address:
City
State	Zip This is my: Home Address Work Address

Please check here if you prefer NOT to have your name and contact information published in the Registrant List:
		Daytime Phone
e-mail address
Preferred session attendance: Jan 29-30, 2009 July 16-17, 2009 October 15-16, 2009
Nusing License #
Other License #
	ADA Requirements:
	Dietary Requirements:

Tuition
	CAHQ Member........................................................		$515
	Register and join CAHQ:
	January session (membership through 12/31/09)........		$590
	July session (membership through 12/31/09)...............		$565
	October session (membership through 12/31/10).........		$595
	Non-member..........................................................		$625
	Course Materials ..................................................... The Healthcare Quality Handbook		*Included! ($165.00 value!)*
	Each participant must purchase the Handbook which is the required text for the course
	CPHQs taking the course for recertification are entitled to an additional $25 discount off any of the fees listed above. Select from the list of fee options for CPHQs on the Online Payment Link Page.
	If you wish to receive your handbook early by mail, check here The 24th Edition will not be available in advance of the July workshop. When you go to the Online Payment Link, check the box to pay the additional $12 fee for this service.
	A $25 processing fee will be charged if rebilling of a credit card charge is necessary

CAHQ, 5360 Workman Mill Rd., Whittier, CA 90601

Form more information, contact CAHQ at 562-695-8400