Certificate of Training in Adult Weight Management
Program Registration Zantr~rc
S 120 scud, Ri.,nide PI.za
Chicago, illinoIs 606064995
ADA MembershlpiReglstratlon number: _____________ 600Th” Ieooestssoo
Participation is limited. Please register by the date I sted below Past certificate programs have been filled to capacity several days prior to the registration
deadline CDR strongly recommends that flight arrangements and hotel reservations not be finalized until written registration confirmation is received
Registration confirmation wilt be sent by e-mail Please be sure to include an e-mail address below The registration fee is $345. Registration includes the home study module, 2
1/2 day onsite workshop—including beverage breaks and post-test Meals are not included) A complimentary copy of the on-site handouts will be available for downloading within
five (5) days of the program A paper copy of the handouts can be purchased at an additional cost of $25 The handouts can be purchased below
Indicate which program you will be attending:
Program Registration Deadline*
Your name and credentials will be published on the program participant
October 21-23, 2009 September21 2009 list distributed to all program attendees. Do you grant permission to
CDR to include your business contact information along with your name
November 9-11 2009 October 12 2009 and credentials?
*A $25 late fee will be added to all registration forms Yes
submitted or postmarked after the posted deadline date
October 2009 November 2009
Payment Amount Program Registration Fee ($345) $________ Program Registration Fee ($345) $________
•*Attend lunch on the second day On-Site Handouts ($25) $_________ On-Site Handouts ($25) $_________
of the program and have the Lunch-with-the Faculty (545)1* $_________ Lunch-with-the Faculty** ($35) $_________
opportunity to ask specific Late Fee * ($25) $________ Late Fee * ($25) $________
questions of the faculty and (include after published registration deadline.) (include after published registration deadline)
network with other participants Total Payment Due $________ Total Payment Due $________
Method of Payment Check/Money Order Visa/MC Discover Mier Exp Purchase Order Number
(Made payable to the Commission on D etetic Registration) (Payment must be received
prior to first day of program
Cancellation Policy If paying by credit card your name and signature below
indicate you agree t the amount being charged to your account and that the
registration fee is no refundable unless written request to CDR is postmarked 30 days First Name Lasi Name Badge Name (if different
prior to the first day of the program A $25 00 cancellation fee will apply if the pre-work
materals have been mailed In the rare nstance that you do not pass the pre-test a
refund will be provided m nus a $50 fee for the home study module Professional Credentials Posisson
Name on Card Federal-Express which does fbi deliver to PU Boxes)
Card # Exp ration Date
Signature Z p code of b fling address Telephone Number Fax Number
If you have a disability that requires special accommodations, please indicate: E-mail address (Required for Registration Confirmation and oilier written communication.)
Business Name and Address ifnoi included above
app cab fl be ~niacted by COR far supplemental information)
(If applicable, you wi I be contacted by CDR for supplemental information.
Please provide us with your emergency contact information in Case we need to contact someone on your behalf while you are at the weight management program
Name Day Time Telephone Evening Phone
I # Online wwwcdrnet.org I Call 1400-877-1600 ext. 5500 I Mail/fax form to: Commission on Dietetic Registration
120 South Riverside Plaza, Suite 2000
Chicago, IL 606064995
# Go to www.cdrnetorg to register on-line. Click on the certificate of training program Fax 1-312499-5364
link on the CDR homepage and choose the adult or childhood program.
n event o canc nato o a certi ca o tr ining rogram any expenses incurred by registrants or prospective participants shall not be the responsibility o CDR
~Due to high convention center hote costs for lunch options for this program, the Lunch & Leam event fee for this program has ncreased from $35.00 to $45.00. The hotel is also
requiring that we have a minimum of 25 participants for this event. Therefore, if 25 participants do not register for the Lunch S Learn event by Friday, October 9, 2009, it wi I be cancelled.
All registrations for this event wit be cancelled with a full refund
Please see brochure for hotel Information.
‘This Certificate Program is only open to members of the American Dietetic Association, Registered Dietitians, and Dietetic Technicians, Registered.
Certificate of Training in
Adult Weight 8001577-1600 ext 5500
October 2 1-23, 2009 Hyatt Regency Denver Hotel
Past FNCE 2009 650 15th Street, Denver, CO 80202
November 9-11, 2009 Melville Marriott Long Island
1350 Old Whitman Road, Melville, NY 11747
Visit the CDR website at www.cdrnet.org for additional program information
Offered by the American Dietetic Association and Commission on Dietetic Registration.
Approved for 28 CPE Hours—Level II
• • • • • • • • • • • •
“This Certificate Program provides much needed and cuffing-edge knowledge and skills
that will enable dietetics practitioners to capitalize on many new and exciting
weight management career opportunities.”
John Foreyt, PhD, Professor, Department of Medicine
Baylor College of Medicine
• • . . • • • • • • • .
Participation is limited. Please register by the registration deadline. (See registration form).
Past certifcate programs have been filled to capacity several days prior to the registration deadline.
CDR strongly recommends that flight arrangements and hotel reservations not be finalized until
written registration confirmation is received.
Hotel Reservations—A limited number of rooms have been reserved at the following hotels. To reserve your room
at the special program rate noted below, please call the hotel by the registration deadline date and mention that you
are attending the ADA Weight Management Workshop. You will need to guarantee your reservation with a major
credit card Payment of all room, tax and incidentals will be the responsibility of each individual.
Denver, Colorado—Hyatt Regency Denver Hotel, 650 15th Street, Denver, Colorado 80202
Please visit the FNCE 2009 housing link at:
https //rms.ambassadors.com/index cfm2shc id2542&inblock=521 50
to make your hotel reservation by September21, 2009.
Melville, New York—Melville Marriott Long Island, 1350 Old Whitman Road, Melville, NY 11747
Rate $172 single/double for the evenings of November 8, 9, and 10
To make your reservation, please call the Melville Marriott Long Island at 800/228-9290 by October 12,2009
participants shall no be the ‘mv expenses incurred
e en o cane Iation ofa certificate of training program.responsibilit~ ofCDR by regist ants or prospect te
Over half of American adults are overweight or obese. There are three components to the certificate of
A dietetics professional, trained to have a comprehen training program:
sive knowledge of the field and management options, • a self-study module (including 7-9 hours of
can enable patient long-term compliance and sus readings, activities, and a pre-test)
the 2 1/2 day live workshop and
This program is designed to produce providers of • a take-home test.
comprehensive weight management care who also
know when and how to refer patients to other special Since understanding the fundamentals of adult
ists. It is open to ADA members, RDs, and DTRs. weight management is necessary to actively
You should attend if you: participate in the workshop, you must pass the
• currently counsel patients regarding their weight pre-test (which is based on the self-study module)
and want to raise your practice level, or to attend the workshop. Those who do not obtain
a passing score will be notified, and given an
• are switching careers to the area of weight opportunity to retest as time permits.
management and need to hone your knowledge
and skills. The workshop will focus on practical, interactive
learning. It will not repeat the didactic
The Certificate of Training offers: information covered in the self-study module.
• cutting edge information and skills shared by After successful completion of the fUll course and
leading practitioners in the field the multiple-choice question post-test (taken at
home after the course), participants will be
• cases and exercises to allow hands on experience awarded a Certificate of Training in Adult Weight
• valuable resource materials and tools for Management, suitable for framing.
immediate use and future reference
an opportunity to showcase your expertise by
All program participants will receive continuing
professional education units; however, only those
. earning a Certificate of Training
who pass the post-test will receive the certificate.
Participants will only be Liven one Opportunity to
pass the post-test
“We are positioned to take the lead in weight management Misinformation is rampant and we need to be
practice to address the world-wide epidemic ofobesity. This cert(flcate program will provide the needed
training and support to help us meet this sign (/lcant challenge.”
Sachiko St. Jeor, PhD, RD, FADA, Professor and Director
Nutrition Education and Research Program, University of Nevada School of Medicine
The expert faculty was wonderful. Ifelt confident that I was getting the most up-to-date accurate
Tammy B Darke, MS RD
Coto De Caza, CA
“Terr(fic program! Very informative. Reinforced many concepts for me and helped me look at new areas,
especially bariatric surgery in a d(fferent way. Thank you to a very professional, knowledgeable, teaching
Judith D 1-leesacker, MS RD CD
I # Online www.cdr.net.org I Call 1-800-877-1600 ext 5500 I Mail/fax form to: Commission on Dietetic Registration
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606-6995
# Go to www.cdmet.org to register on-line. Click on the certificate of training program Fax 1-312499-5364
Current Research and Future Possibilities... Clinical Management of Overweight and
Obesity... OTC Dietary Supplements... Behavior Modification... Application of Popular
Diets and Weight Loss Programs... Formulas for Weight Loss... Medical Complications of
Weight Loss... Role of Exercise... Pharmacotherapy... Bariatric Surgery as a Treatment
Option... Case Studies
*Please note that times are subject to change. A final agenda will be sent with the pre-work materials.
October 2 1-23, 2009
Wednesday Thursday Friday
8:00 am 6:00 pm 8:30 am—6:00 pm 8:30 am 1:00pm
November 9-11, 2009
Monday Tuesday Wednesday
8:00 am—6:00 pm 8:30 am 6:00 pm 8:30am 1:00pm
. (8:00 am check-in 8:30 am session begins)
Susan M. Cummings, MS, RD Molly Gee, Med, RD
Robert Kushner, MD Cathy Nonas, MS. RD, CDE
Christina Biesemeier, MS, RD, ED, FADA Diana Radler, PhD, RD
Ruth Ann Carpenter, MS, RD Allison Schimmel Matson, MS, RD
John Foreyt, PhD, Professor Cynthia A. Thomson, PhD, RD
Gary Foster, PhD
*Program faculty to be selected from this list. Faculty vary by program.
A team of over thirty leading experts in the field of weight management contributed to the development
and review of this certificate of training course, including George Blackburn, MD, Kathleen Cobb, MS,
RD, CD-N, John Foreyt, PhD, Gary Foster, PhD, James Hill, PhD, Marsha Hudnall, MS, RD, CD,
Laura Kettle Kahn, PhD, Robert Kushner, MD, Paul Larson, MD, Richard Mattes, MPH, PhD, RD,
Cathy A. Nonas, MS, RD, CDE, Rebecca Reeves, DrPh, RD, FADA, Judith Stern, PhD, RD, Sachiko
St. Jeor, PhD, MS, RD, FADA, Robert Wilson, DTR, and Babette Zemel, PhD.