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Making a Difference:  A Medical Surgical Specialty Nursing Conference
Friday, November 20, 2009
Hershey Lodge
Hershey, PA

Pay by credit card:
Submit your registration information below then call (717) 531-6483 to complete your credit card payment.  You may also download the credit card payment form and mail or fax to:

Department of Continuing Education, G220
Penn State College of Medicine
P.O. Box 851
Hershey, PA  17033-0851
Fax:  (717) 531-5604

Pay by check:  Make checks payable to Penn State, and mail to:

Department of Continuing Education, G220
Penn State College of Medicine
P.O. Box 851
Hershey, PA 17033-0851

Include a note with your check indicating that your registration was submitted via the Web page.
 
 

 

 


Area
Information

 

Authorized billing:
If you would like us to bill your organization, company, or institution, please send a letter of authorization to bill to our mailing address. The letter must be signed by an individual in your organization with the authority to make this contract. Registration will be confirmed upon receipt of the billing authorization. (A copy of the authorization can be faxed to 717-531-5604, however, we must have the original copy sent to us.)

Conference Brochure

Registration confirmation:
Registration will be confirmed upon receipt of payment, billing authorization, or a guarantee by credit card. If you do not receive a confirmation within two weeks, please call (717) 531-6483 to confirm.

Name:
How would you like your name to be printed on your nametag:
Degree:
Specialty:
Date of Birth:
(used as an identifier)
Home Address:
City:
State:
Zip Code:
Organization:
Business Address:
City:
State:
Zip:
Day Phone:
E-mail:
Fax:
Evening Phone:
Choose one Breakout in each Session (three total):
Breakout 1 1A, Update Your Care of Patients with Diabetes
1B, Legal Issues:  Am I at Risk?
Breakout 2 2A, Your Mother Was Right-Nutrition Matters
2B, When Nurses and Patients Disagree
Breakout 3 3A, Homeward-Bound, Chronically Ill Patients
3B, Critical Thinking Becomes YOU
   
Registration Fee: $125 per person  
I wish to be considered for one of the limited student nursing $75 fees. I have included a letter from my school director.                                
HMC/COM Employee Fee, $90
   
Payment Method: Credit card to be submitted via:
      fax
      mail
      phone
Authorization to bill employer
Check
 

Additional payment options for HMC/COM employees only

IDCC
COM employees only. Send to department ID &HCE. Include IBIS document # in memo field below.
IDT
HMC employees only. Send via interoffice mail to Continuing Education G220.
Memo to bill department
HMC employees only. Send via interoffice mail to Continuing Education. Include budget # and authorized signature.
Memo:
Please provide any additional information or questions you have concerning this registration.
Do you require special services (i.e., handicapped access, hearing impaired, etc.), and if so, what services do you require?

By pressing the "Send Registration" button below, the information will be submitted to the Continuing Education office via our secure server. Your registration will be confirmed via e-mail within one week. Your registration is not complete until you receive a confirmation from ContinuingEd@hmc.psu.edu via e-mail.

    

 

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For suggestions or comments about the Penn State Hershey Continuing Education web site, please email ContinuingEd@hmc.psu.edu.



Penn State Milton S. Hershey Medical Center ©2004
This page was last updated on November 03, 2009
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