Nurses Expo Registration 2024 - Stateline Nurses Network

Name*

First Last

Credentials*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Personal Email*

Work Email*

Employer*

Job Title/Position*

BREAKOUT SESSION CHOICES – (see brochure/speaker document PDFs on our website for more details)

o 10:15-11:30 AM*

o 12:30-1:45 PM*

o 1:55-3:10 PM*

T-Shirt Size (Must Submit by April 12th) **

Registration Fee*

Price:

Fee includes registration and $20 for Stateline Nurses Network Annual Membership dues beginning April 1, 2024

Online Payment Fee*

Price:

Total

$0.00

Credit Card

Card Details

Cardholder Name

Cancellation Policy: For those canceling after April 12th, a $50 fee will be charged to cover refreshments/processing No refunds for no-shows