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RHODE ISLAND SOCIETY FOR RESPIRATORY CARE

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					               RHODE ISLAND SOCIETY FOR RESPIRATORY CARE
            NEWPORT CHALLENGE CONFERENCE REGISTRATION FORM
                                  2008



Name: ________________________ Credentials: ___________                                 AARC Membership No: ___________

Address: ____________________________________________                                       RCP No:
_______________________

Hospital: ___________________________________________                                    City/State/Zip:
___________________

Phone #___________________ Attending: Thursday________ Friday_________ Both
Days__________

Email Address
_________________________________________________________________________
---------------------------------------------------------------------------------------------------------------------------------
REGISTRATION FEES:                                                               NOTE: If non-members join the AARC,
                                                                                either prior to the conference or at the
                                1 day                         2 days              door, they will be charged the AARC
                                                                                member fee. AARC members shall
AARC Members                      $ 85.00                     $110.00              present membership cards at the
Non-Members                       $150.00                        $200.00                 registration desk.
Student AARC Members $ 0.00                                     $ 0.00
Student Non-Members $ 50.00                                     $100.00            Please make check payable to RISRC
                                                                                Mail registration form and check to:

Advanced Registration and payment of fees are required by                             Craig Tucker, RRT
March 27, 2008. Lunch on Thursday and Friday is included.                            191 Walker St.
On-site registration fee is an additional $15.00.                                    Lincoln, RI 02865

Lunch for Student AARC Members not included.
Lunch may be purchased.

                                         ***AARC, 12 CRCE Credits Applied for***

For more information, please contact:

Albert Fantasia                   401 444-4807                                   afantasia@lifespan.org

Rebecca Jackvony                                                                 rjackvony1@cox.net

Linda Boisclair                       401 788-1848                                lboisclair@schospital.com

				
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