End of Life Care Conference Registration

Conference Registration

Thank you for your interest in the upcoming conference entitled End of Life Care: Care and Choice at the End of Life scheduled for Monday, October 16, 2017 at the beautiful Lake Lodge in Alfred, New York. Pre-registration is required to attend this event no later than October 10, 2017 by completing the information below.

* Indicates required field

Name *

First

Last

Organization *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Title *

Phone Number *

Fax Number *

Email *

Confirmation Notices will be sent via email.

Dietary Restrictions *

Payment

Cost of the conference includes continental breakfast, lunch and all training materials. To be entitled to the group rate, 3 or more attendees must register from the same organization.

Conference Registration Fee *

Individual $45.00 Group Member: $40.00

Form of Payment *

Please Send Invoice Check Purchase Order

Checks should be made payable to Ardent Solutions, Inc. All cancellations must be received five (5) business days in advance of the event. If notification is not received and/or a substitute is not available to take your place, you will be billed for the full amount.

Continuing Education Hours

(Full attendance is required; partial credit is not given for partial attendance)

NY Social Workers: Offered in collaboration with the UB School of Social Work Office of Continuing Education, recognized by NYSED’s State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0001. 6.5 live in-person contact hours are approved.

NY Mental Health Counselors: Offered in collaboration with the UB School of Social Work Office of Continuing Education, recognized by NYSED’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors #MHC-0008. 6.5 live in-person contact hours are approved.

ADA Accommodations and Customer Support

If you require any support for your ADA needs, or have any concerns or questions, please contact us by email at least 3 weeks prior to the event at evansh@ardentnetwork.org or by phone at 585-593-5223 ext. 1011.

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