Upcoming educational events for California Association of Healthcare Quality Members

The 2010 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: February 11-12, 2010 July 15-16, 2010 October 14-15, 2010
Nusing License #
Other License #
	ADA Requirements:
	Dietary Requirements:

Tuition
	CAHQ Member........................................................		$540
	Register and join CAHQ:
	February session (membership through 12/31/10)........		$635
	July session (membership through 12/31/10)...............		$610
	October session (membership through 12/31/11).........		$640
	Non-member..........................................................		$670
	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, United States military and participants who have attended a workshop within the past 12 months are entitled to an additional $25 discount off any of the fees listed above. Select from the list of discount fee options on the Online PayPal Link Page that follows.
	If you wish to receive your Handbook early by mail, check here The 25th Edition of the Handbook will NOT be available in advance of the July workshop. If you wish to receive the 24th edition in advance of the February workshop or the 25th Edition in advance of the October workshop, check the box on the PayPal page to pay the additional $15 fee for this service.
	Cancellations/Refunds/Transfers: Cancellations will be accepted if received or postmarked at least 14 days prior to the event date and are subject to a $75 processing fee to cover costs. In lieu of a refund, with payment of an additional $75 processing fee, you may transfer to another scheduled workshop during the current year, space permitting.
	A $25 processing fee will be charged if rebilling of a credit card or PayPal charge is necessary.

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

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