Register below for the Clinical Connections Educational Session brought to you by GE Healthcare, Maternal-Infant Care

Which session of Clinical Connections will you be attending – please select ONE.
February 10, 2009 - Phoenix
  March 10, 2009 - Birmingham
April 7, 2009 - Denver, CO
Coming soon - pdf with agenda and location
  May 5, 2009 - Minneapolis
Coming soon - pdf with agenda and location
  May 19, 2009 - Seattle
Coming soon - pdf with agenda and location
  August 12, 2009 - Detroit
Coming soon - pdf with agenda and location
  August 26, 2009 - Edmondton, Canada
Coming soon - pdf with agenda and location
October 13, 2009, New York
Coming soon - pdf with agenda and location
  Tell Us About Yourself
Your Name:
Address:
City:
State:    Zip/Postal Code: 
Country:
Phone:
Email Address:
Years of Experience:
Position/Title:
Facility Name:
For medical professionals only
Facility Type:
For medical professionals only : 
What type of microenvironment do you own? (select all that apply):  
Giraffe® Incubator
  Giraffe® OmniBed®
  Giraffe® Warmer
To process your CEU credits, please input:
RN Licence Number
Last 4 digits of Social Security Number:
State:
Cost $75, Please Select Your Payment Method:

Credit Card (Do not supply credit card number; we will contact you)
Credit Card Holder and Billing Address:
Purchase Order Number:
PO# :
Please fax billable PO to 262-574-8813 (Waukesha) or 608-223-6700 (Madison)

Click on Submit below to submit your registration. The Clinical Connections coordinator will send you a confirmation email. Contact Erin Kedzierski: Erin.Kedzierski@med.ge.com or 800.527.9209 ext: 5311