:. Registration .:. CAHB .:

Registration Form

Nurse 2008

– Universal Health Care System: International Nursing Perspective –

March 21, 2008

Submit this form online and send your check to:

Center for the Advancement of Health and Biosciences
1230 Bordeaux Dr., Suunyvale, CA 94089
Tel. (480) 400-0107
Fax. (408) 400-0977

Registration fee (check only):

General:

$170 - Before 3/20/2008
$200 - On Site

Student:

$120 - Before 3/20/2008
$150 - On Site

Continuing Education (CE) certificate from UCSF School of Nursing (seven hours):

$10

*Note: Registration cancellations must be requested in writing by February 15, 2008. A $50 administrative fee will be deducted from refunds through that date. No refunds thereafter.

Please make your check payable and send to:

Center for the Advancement of Health and Biosciences or CAHB

First Name * : Middle Initial: Last Name*:

Title: Degree(s):

Speciality: Department:

Institution/Company name:*

Address*:

City/State/Zip * : Country*:

Daytime Phone: Fax:

E-mail address*: Comments:

CE Certificate ($10) : Yes No

If "Yes", please write your registered Nurse Number (if you have one):

Which State?:

Are you a student? : Yes No

If yes, please bring your student ID with your photo and show it at the registration desk.

We will send you confirmation email including your registration information after we receive your application.

If you have any question or comment, please contact Yuko (kanamori@cahb.org).

Center for the Advancement of Health and Biosciences
1230 Bordeaux Dr., Suunyvale, CA 94089
Tel. (480) 400-0107
Fax. (408) 400-0977
info@cahb.org

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