PRE-CONVENTION PROGRAMS REGISTRATION by exuberantsun

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									                                                                                  PRE-CONVENTION PROGRAMS
                                                                                       ■ REGISTRATION ■

                                                                               NCPA 111th Annual Convention and Trade Exposition
                                                                              Ernest N. Morial Convention Center • New Orleans, LA
                                                                                                                  October 17–21, 2009

 NIPCO Community Aging, Assisted Living, and Long-Term Care Certificate Program (Oct. 15–16)
     Member .................................................................................................................... $750
     Non-Member ........................................................................................................ $1,200

 The Business of Profitable Compounding Services (Oct. 17)
     Member .................................................................................................................... $995
     Non-Member ........................................................................................................ $1,295
 OWNERSHIP ACADEMY How to Buy a Pharmacy (Oct. 17)
     Member .................................................................................................................... $195
     Non-Member ........................................................................................................... $395

 OWNERSHIP ACADEMY How to Sell a Pharmacy (Oct. 17)
     Member .................................................................................................................... $225
     Non-Member ........................................................................................................... $425

 Technology Bootcamp: Essential Information Appliance Skills (Oct. 17)
     Member .................................................................................................................... $100
     Non-Member ........................................................................................................... $300




name	 	                 	          	           	           	              	         	            	           	           	              	        	    	       	       ncpa	member	#


pharmacy/company	name


Address


city	     	             	          	           	           	              	         	            	           	           	              state	   	    	       	       	              zip


telephone	              	          				        	           														 	         cell	phone	              	           	              	        		   	       fax


e-mail			



Payment
 Enclosed is my check (made payable to NCPA) $__________________ (in U.S. funds drawn on a U.S. bank).
 Please charge $__________________ to my credit card:                                   Visa  MasterCard  American Express  Discover


card	number	        	          	          	           	          	            	         	            	        exp	date		            	        	        	   	         security	code*


cardholder	name	(please	print)	           	           	          	            	         	            	        cardholder	signature	(required)


* Security code is the three-digit number on the back of credit card or four-digit number on the front of American Express card.




                                                                          Fax or mail completed form with payment to:
                                                                                  NCPA Pre-Convention Programs
                                                                                        100 Daingerfield Road
                                                                                          Alexandria, VA 22314
                                                                                     Tel: (703) 683-8200, ext 670
                                                                                           Fax: (703) 683-3619

								
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