ASPIN | Registration Form

First Name:		Last Name:
Company/institution				Email
Address				Phone
City		State				Zip
Training Session		Specific Clinical Training
Training Date(s) or comments

ONLINE Training:	Case Management Module One Module Two Module Three Module Four Module Five
Labor Law Series	Session 1: Overview of Employment Law for Managers:		6-19-08		2-4 pm
	Session 2: Managers Guide to ADA:		7-17-08		2-4 pm
	Session 3: FLMA:		8-14-08		2-4 pm
	Session 4: Discipline and terminations		9-18-08		2-4 pm

Payment:
Check	Invoice my facility ( ASPIN members only)					Check here if you would you like to be notified of training information via email

ASPIN's mailing address: 3600 Woodview Trace, Ste. 103, Indianapolis, IN 46268.
For questions please contact LaVette, phone 317-471-0000.

Registration deadline: 5 business days before the day of training. Late fee of $10 added for registrations submitted after the deadline. Registrations not refundable for cancellations made after the registration deadline. No refunds for no-shows.

Thank you for your registration.!

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Standard Fees:

Clinical : Members: $50.00 Affiliate and Panel Providers: $100.00 Non-Members: $150
Supervisory Skills: Cost: Members: $75.00 Affiliate and Panel Providers: $125.00 Non-Members: $150.00
Management: Members: $100.00 Affiliate and Panel Providers: $150.00 Non-Members: $175.00
Case Management: Members: $75.00 Affiliate and Panel Providers: $125.00 Non-Members: $150.00

NOTE: Fees will vary for some trainings.