Registration form: Third Annual MNA Clinical Nursing Conference
May 23, 2008

This is a FREE conference for all MNA members $75 placeholder fee will be returned at registration on May 23rd

Please print clearly.

Name: _________________________________________________________________________________

________RN ________APN ________Other (specify) _________________________________________

Address: _______________________________________________________________________________

City/Town: ___________________________________________ State: _______ Zip: ________________

Telephone: Daytime: __________________________ Evening: ___________________________________

Email (for confirmation): __________________________________________________________________
(Only email confirmations will be sent).

Please indicate your "1st," "2nd," and "3rd" choice for the following morning concurrent sessions:

________Diabetes ________Obesity ________Surgery ________Sepsis ________Evidence-Based Practice

Please indicate your "1st," "2nd," and "3rd" choice for the following afternoon concurrent sessions:

________ST Segments ________Infectious Diseases ________What To Say ________MABORN

Every effort will be made to accommodate your selections.

To register please return the completed form
with your check payable to MNA for the placeholder fee of $75 to:
MNA - Attn. Liz Chmielinski - 340 Turnpike Street - Canton, MA 02021

Registration is by mail only, will be on a space available basis, and will close once seating capacity Registration