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Continued Education - Registration Form
Not for use in registering for Annual Updates or ACLS Programs (please use the registration forms attached to the brochures for these programs).

Complete the form online and printoff a copy. Have the form signed by the appropriate manager and return to the attention of: Nursing Education Secretary, Room #4425 no later than three (3) weeks prior to the class.


Name:
Unit:
Classification:
RN    LPN   SA
 
Other (specify):
Please register me for:
Scheduled for (date):
 
Nurse Manager Approval:

_______________________________________________

Complete one registration form for each class/course you wish to attend. Registrations will not be accepted without a Nurse Manager's approval signature. Also, please give a copy of the registration form to your unit's scheduler.

   

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