NMHCA 

 

Workshop Registration

Tell us how to get in touch with you:

Facility/Organization:
Name
Address
E-mail
Tel
FAX

Which Workshop are you registering for?

                                                    

What is your membership Status?

Member   Non-Member  Non-Facility State Employee
 

                                      

    

Please enter the name and title for each person you are registering, (i.e. John Doe, Executive Director:)

Name and Title      Name and Title

Name and Title      Name and Title

Name and Title      Name and Title

Name and Title      Name and Title

Name and Title      Name and Title

 
If you do not receive a confirmation form within 7 days, please contact NMHCA to verify your registration was received. NMHCA will invoice all members. Non-members must submit payment in full BEFORE the event. Space is not guaranteed for non-members until payment is received.  

On-line Payment


Copyright © 1999 New Mexico Health Care Association. All rights reserved.
Revised: February 14, 2008 .