Please print on your computer and fill out and mail
or e-mail Cyndi@RealNurseEd.com to register by e-mail
Payment must immediately follow by mail
or use PayPal

Name_________________________________

Address_______________________________

City/State/Zip___________________________

Telephone (home)_______________________

e-mail_________________________________

Employer______________________________

Your title ______________________________

License Number_________________________

Conference Fee
Full Pre-registered Price $75_____________

Employees
discount price: $50 ___________

Add $10 if registering after deadline or at the door (if space is available) _______
No guarantee of seating if not pre-registered

Discounts: (Received by early bird deadline in the same envelope)
$5.00 off per registrant for groups of 3-5
$10.00 off per registrant for groups of 6-10
$15 off per registrant for groups of 11-15
$20 off per registrant for groups >16

Please send check or money order made out to:
Cynthia F. Cramer
PO Box 353
Trilby, Fl
33593-0353
or pay online at PayPal

Contact: Cyndi@RealNurseEd.com if you have any questions.