Upcoming educational events for California Association of Healthcare Quality Members

The 2012 Healthcare Quality Overview and Certification Workshop
Online Registration Form

Name:
Title:
Organization::
Mailing Address:
City
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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 2-3, 2012 July 12-13, 2012 October 11-12, 2012
Nusing License #
Other License #
	ADA Requirements:
	Dietary Requirements:

Tuition
	CAHQ Member........................................................		$545
	Register and join CAHQ:
	February session (membership through 12/31/12)........		$640
	July session (membership through 12/31/12)...............		$615
	October session (membership through 12/31/12).........		$645
	Non-member..........................................................		$675
	Course Materials ..................................................... The Healthcare Quality Handbook		*Included! ($170.00 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.
	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, 4570 Van Nuys Blvd. #326, Sherman Oaks, CA 91403

Form more information, contact CAHQ at 800-230-3163