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Continuing Education Registration Form

Module/Workshop:

Care of the Older Adult Physical Assessment and Case Studies (Restricted Registration) Other Workshop (Please Specify Below)
Other:

Workshop Start Date: (mm/dd/yyyy)  

For Care of the Older Adult Module, put today's date.

  • Physical Assessment and Case Study Review Workshop 09/26/2017

 

 

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First Name (This is the name that will appear on your certificate):

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Last Name (This is the name that will appear on your certificate):

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Address:

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City:

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County:

Annapolis Antigonish Cape Breton Digby Colchester Cumberland Guysborough Halifax Hants Inverness Kings Lunenburg Pictou Queens Richmond Shelburne Victoria Yarmouth

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Province:

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Postal Code:

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Home Phone:

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Email: Please provide the email address that you check most frequently.  This is our most frequent method of correspondence.

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Please Confrim Your Email:

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Professional Designation / Occupation:

RN LPN RSW OT RT CCA

Other:

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Health Authority:

NSHA - Western NSHA - Northern NSHA - Eastern NSHA - Central IWK

Other:

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Current Employer / Facility:

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Work Location:


*Please note (COA applicants only): Your registration will not be processed without full payment. Credit card payments are available at the RNPDC office or by calling 1-800-461-8766
No refunds will be issued after online access to the materials is granted.