The Licensed Practical Nurses Association of Alabama is proud to present it's
65th Annual Convention on May 9 & 10, 2013
Auburn University of Montgomery
7400 East Dr.
Day 1 at Nursing Building -- Day 2 at Library Tower -- West Room
on Nursing Blvd.
LPNAA Member Yes ( ) No ( ) If yes, What Chapter __________
Please check correct credentials: LPN __________ RN __________
Full Name: ____________________________________________________________________
Mailing Address: _______________________________________________________________
City: _________________________________________ State __________ Zip __________
Home Phone: __________________________ Work Phone: ____________________________
Employer: ____________________________________________________________
Enter the appropriate fee and include payment. Pre-registration must be submitted by
April 26, 2013. Registration includes an AM break and lunch.
Students $10.00 Educators $40.00 Educators will receive CE's
LPN MEMBERS $110.00 NON-MEMBERS $130.00 DOOR PAYMENT $160.00
Registration after April 16, 2013
Members $120.00 Non-Members $130.00 DOOR PAYMENT $160.00
Total Registration Payment Sent: ________________________________________________
Please mail registration fees by CHECK or MONEY ORDER to the following address. Cancellation fee of $15.00 per person will be charged. ON SITE registration will be CASH ONLY. Contact Hours will be handed out at the end of the day. Please bring your NURSES LICENSE for scanning. Please bring a sweater or wrap if needed.
Alabama Provider Number ABNP0008 2/13/10 to 2/13/14
Mail Payment to: James Selmar
4013 Ray Dr.
Montgomery, AL 36109
If cancellation is required contact: James Selmar 334-558-1435.
HOTEL RESERVATIONS ON YOUR OWN AT HOTEL OF YOUR CHOICE.
