Registration Form

NCEHS
23640 Scenic Loop Road, Bldg. #2
San Antonio, TX 78255

To register, please complete the registration form and forward with fees to NCEHS, 23640 Scenic Loop Road, Bldg. #2, San Antonio, TX 78255. Call 210-698-8700 to register or for information. Fax to 210-698-8701. Call 210-698-8700 to register with MasterCard, VISA, AMEX or Discover. Refer to deadlines. The pre-registration fee is $129 per person/per day to 1/20/02 by date of receipt; $149 per person/per day 1/21/02 - 1/28/02 by date of receipt; $179 per person/per day 2/1/02 - 2/05/02 by date of receipt; $199 per person/per day after 2/5/02 and at the door (please call to verify space availability if not reregistered). $119 per person/per day group discount for 3 or more, registering together on the same form is available until 1/20/02. Fee payment completes the registration process and the registration form is received is the registration date. Cancellation with full refund minus a $25 fee is available up to 1/20/02. Letters of credit will be given for course cancellation by registrants after 1/20/02. Substitutions will be accepted up to one day before the course, only with notification. No substitutions/cancellations are accepted on the day of the course. Registrants who do not attend/call forfeit their fees. A certificate will be awarded to all that complete the entire day (s). Each offering is approved for 6.0 contact hours for each entire day of course attendance. NCEHS has been awarded Provider Status by the Texas Nurses Association (TNA), which is accredited as a approver of continuing education for nurses by the American Nurses Credentialing Center (ANCC). This approval meets Type I criteria for mandatory, CE requirements toward relicensure as established by the Board of Nurse Examiners for the State of Texas. Social Work credit approved. If commercial products are displayed during this program it does not imply NCEHS, nor ANCC or TNA approval or endorsement of any such commercial product (e.g. book, manuals, tapes). Treasury Regulations do allow income tax deductions for educational expenses undertaken to maintain and improve professional skills. Confer with your CPA for details. NCEHS reserves the right to alter the format of the program to accommodate unforeseen events. If you do not reregister, please call to verify seminar availability and course information prior to attending.

Rates are based on date of receipt via email, date of envelope postmarks with registration forms and money, or date of receipt via fax.

Please Fill Out Information Below:

First Name:

Last Name:

If Two Or More, List Names:

SS# For Contact Hour Record:

Agency:

Address:

City:,  

(E-Mail):

H) Phone:

(F) Phone:

(W) Phone:

Title:

RN LVN Aide Soc. Worker Other

Credit Card Visa Mastercard AMEX

Account Number:Exp. Date

Cardholder Name:

(Make sure you enclose your check or credit card information)