Nurse Round Table

Hosted by:

Far Brook School

52 Great Hills Rd.

Short Hills, NJ 07078

Thursday, May 2, 2019

5:00 p.m. - 7:30 p.m.

Please join this wonderful group of health professionals to collaborate and connect across the association.

$50 NJAIS Member Schools, $100 Non-Member Schools

Light refreshments provided

Registration Form

Number of Registrants from My School:required

Registrant 1:

First Namerequired

Last Namerequired

Emailrequired

Position/Titlerequired

Dietary Restrictions

Vegetarian Gluten-free

Registrant 2:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 3:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 4:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 5:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 6:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 7:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 8:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 9:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

Registrant 10:

First Name

Last Name

Email

Position/Title

Dietary Restrictions

Vegetarian Gluten-free

School or Organizationrequired

(Non-member schools please complete section below as well)

Non-Member School/Organization Address

Address 2

City

State

Zip

Non-Member School/Organization Phone Number

(where we can reach you and for billing questions)

MEMBER INFORMATION: If your school is a member of NJAIS, upon receipt of your registration, we will automatically generate an invoice and send it to your Business Office. Payment is not required at the time of your registration. Your school will have 30 days to pay the invoice.

NON-MEMBER INFORMATION: If you are an employee of an organization or school that is NOT a member of NJAIS and you are registering for this workshop, please provide the company/school address. We will automatically generate an invoice and send it to your Business Office. Payment is not required at the time of your registration. Your school will have 30 days to pay the invoice. Thank you.

Cancellation Policy:

For Round Tables: Registration fees will only be refunded if NJAIS is notified of your cancellation one week prior to the program.

For Workshops, Conferences and Retreats: Registration fees will only be refunded if NJAIS is notified of your cancellation two weeks prior to the program.

In the event of inclement weather, programs may be delayed or postponed.