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Women's Health:
Contemporary Challenges

June 12-16, 2006  •  UCSF School of Nursing

Registration Form

(Please Print or Type.)

Name

Address

City, ST ZIP

Telephone

Email

California Nrsg. License No. (RN license number is required for continuing education credit.)

Skills Training Sessions             ___ Session A - EMB        ___ Session B - IUD             ___ Session A - EMB        ___ Session B - IUD Indicate above your first and second choices for each skills training session.    Session size is limited. Assignments are made in the order they are received.

Conference Registration Fees

Item	Postmark before  3/14/2006	Postmark after  3/13/2006	Please Write In  Appropriate Fee
Conference Tuition	$545	$595	$
UCSF Employee or FHCN Non-Salaried Faculty Conference Tuition	$245	$295	$
Conference Cost per Day	$150	$150	$
Total:			$

Payment and Registration

Payment will be accepted by check only, payable to UC Regents.

A $20 fee will be charged for any returned check.

Send check and registration form to:

Women's Health: Contemporary Challenges Conference
c/o Claudia Schumann
2 Koret Way, #N-411Y; Box 0606
San Francisco, CA 94143-0606

Questions

If you have questions about the conference, please contact Claudia Schumann by telephone at 415/476·4587.

Links

• "Women's Health: Contemporary Challenges" - home page
• UCSF School of Nursing (Home Page)

For more information, contact claudia.schumann@nursing.ucsf.edu
Revised:  Jan. 2006      
© Copyright 2006 University of California Regents, All Rights Reserved.