AAHFN 16th Annual Meeting On-Demand Registration

Name*

First NameLast Name

AAHFN Membership Number (if active member)

Company*

Position/Title*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Email*

example@example.com

YesNo

How did you learn about the AAHFN meeting?

YesNo

What is your primary discipline?

Please indicate your profession:

Clinical Practice

Please indicate which practice setting best applies to you:

Practice Location:

Years of Nursing Experience:

What is your career level in Heart Failure?

Do you require special attention to fully participate in the Virtual AAHFN 16th Annual Meeting? The American Association of Heart Failure Nurses fully complies with the legal requirements of the Americans with Disabilities Act rules and regulations.

Please indicate if you do or do not want your e-mail address shared with exhibitors and sponsors from the Virtual AAHFN 16th Annual Meeting

I have read and agree to comply with the cancellation policy.

My Products

On-Demand Meeting Registration

On-Demand Full Conference Registration

$199.00

Student Registration

On-Demand Student Conference Registration **Individuals who are enrolled in full-time programs studying to become registered nurses (RN) are eligible for the student registration fees. Students must verify their status by providing a copy of their current enrollment documents or a letter from a faculty adviser.

$99.00

Pharmacology Workshop

On-Demand Pharmacology Workshop

$135.00

MCS Bootcamp

On-Demand MCS Bootcamp

$79.00

Donate to the Heart Failure Patient Foundation

Show your appreciation for your co-workers and fellow nurses by making a donation in their honor to the organization that is dedicated to advancing nursing education, clinical practice, and research, to improve heart failure patient outcomes. The Heart Failure Patient Foundation is a 501(c)3 organization. Donations made to the Heart Failure Patient Foundation are tax-deductible. To skip, but 0 in the quantity section.

$1.00 Quantity

2012 Annual Meeting Fee

$1,604.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country