REGISTRATION FORM


Send registration and full tuition fee (no later than 3 days prior to program) to:
The Center to Promote Health Care Studies, Inc. 14 Colvin Road, Scarsdale, New York 10583
Telephone: (914) 725-4893 / Fax: (914) 725-6489
Upon receipt of payment The Center will contact the registrant for confirmation.

Name:_______________________________________Title:________________________

Home Address:___________________________________________________________

City:________________________________________ State:_______ Zip:____________

Employer:________________________________________________________________

Work Address: ___________________________________________________________

City:________________________________________ State:_______ Zip:____________

Home Phone: _______________________ Business Phone:______________________

E-Mail Address: ____________________________  Fax number:__________________
Check enclosed:
$_____________
Date (s) of Seminars:
____________
____________
____________
____________

 Training Locations: 

Dewitt Nursing Home
211 East 79th Street (Between 2nd and 3rd Ave.)
New York, NY 
Three blocks from the Lexington Ave. -  77th St. Subway Station
(212) 879-1600

Parker Jewish Institute for Health Care &  Rehab

271-11 76th Avenue

New Hyde Park, New York

(718) 289-2100 or 516 247-6500

Lakeville Rd. Exit off the Northern Parkway.  Next to L.I.J. Medical Ctr.

   

(800) 689-8459 / info@centerfortraining.com
All Content © 2001 The Center to Promote Health Care Studies, Inc.