AO ASIF Nursing Continuing Education
A Basic Course for Operating Room Personnel

Please do not consider yourself registered in this Course until written confirmation is received.

Course Name:

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AO ASIF CONTINUING EDUCATION

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Signature (Signature of card holder required, if faxing or mailing form):

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Home address:

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Office Phone:

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Name and City of Hospital:


AO ASIF Consultant:

• Registration is required in advance and is not accepted unless accompanied by appropriate fees. Phone-in registrations not accepted.
• Please do not consider yourself registered for this course until written confirmation is received.
• Registration deadline: June 13, 2003. Refunds will be issued if written cancellation is received by this date.

Do you have any special needs:

If you are registering and paying by check, please print and mail this registration form with payment to:

AO ASIF Nursing Continuing Education
RE: El Paso ORP Course
1301 Goshen Parkway
West Chester, PA 19380
Tel (800) 535-2369 (press 5)
Fax (610) 719-6532

Please do not consider yourself registered for this course until written confirmation is received.

Please press this button to submit your
registration form online using your credit card:

Thank you.