NJENA 2011 EMERGENCY CARE CONFERENCE Registration Form Mailing Information
Information for Name Badge
________________________________________________________ Name
________________________________________________________ Nickname (optional) for top of badge; first name will be used if none
________________________________________________________ Home Address
________________________________________________________ Credentials (RN, LPN, CEN, BSN, etc.)
________________________________________________________ City, State, Zip Code
________________________________________________________ Work Title (Staff Nurse, Manager, etc.)
________________________________________________________ Phone
________________________________________________________ Employing Hospital / Business
________________________________________________________ Email Address (email confirmation will be sent when listed)
________________________________________________________ Employer City, State
Course and Event Selection Place selected course number on line. We suggest you arrive early for classes as seating may be limited and courses will be closed 15 minutes following the class start time. Course selection is for planning purposes; seating is on a firstcome, first-serve basis. No standing is permitted in the classrooms by fire code.
Wednesday, March 16, 2011
Thursday, March 17, 2011
Friday, March 18, 2011
PRE-SESSIONS: See reverse for extra fees required. Please avoid overlapping times.
7:30 am – 9:00 am
7:45 am – 9:00 am
Course 101 CEN Review
Opening Course 201
Yes
No
Course Choice: _______________
9:30 am – 10:45 am
9:45 am – 11:00 am
Course 102 CPEN Review
Course Choice: _______________
Course Choice: _______________
Course 103 EKGs made EZ
11:15 am – 12:30 pm
11:20 am – 12:35 pm
Course Choice: _______________
Course Choice: _______________
2:00 pm – 3:15 pm
1:35 pm – 2:50 pm
Course Choice: _______________
Course Choice: _______________
4:00 pm – 5:15 pm
3:10 pm – 4:15 pm
Course 104 Wound Repair Techniques
Onsite registration for pre-sessions is on a space available basis. 5:00 pm – 8:00 pm NJ State Council Meeting
Yes
No
8:00 pm – 10:00 pm Wine/Cheese Reception
Yes
No
Closing Course 341
Course Choice: _______________
Yes
No
7:30 pm – 10:30 pm NJENA Party
Yes
No
A copy of your ENA Membership Card MUST be included to take advantage of member rates.