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National Association of Psychiatric Health Systems (NAPHS) Annual Meeting 2013

Published on: Mar 3, 2016
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Transcripts - National Association of Psychiatric Health Systems (NAPHS) Annual Meeting 2013

  • 1. ONLINE registration now available at www.naphs.org/AnnMeeting/index.Or use this form to register. 2013 Annual Meeting National Association of Psychiatric Health Systems REGISTRATION FORM Name (print as you’d like it to appear on your badge): __________________________________________________________ Title: ___________________________________________________________________________________________ Affiliation:________________________________________________________________________________________ Street:____________________________________________________________________________________________ City/State/Zip______________________________________________________________________________________ Telephone: ___________________________________________ Fax: _______________________________________ E-mail: __________________________________________________________________________________________ Registration Fees:  Members (of NAPHS): $675  Nonmembers: $750 TOTAL: $ ________________________ NOTE: Registrants unable to attend may send an alternate. Please send completed registration form and payment to: NAPHS, Annual Meeting, 900 17th Street, NW, Suite 420, Washington, DC 20006-2507 Phone: 202/393-6700 Fax: 202/783-6041 E-mail: naphs@naphs.org For questions about meeting registration, please call Maria Merlie at 202/393-6700, ext. 104. Cancellation Policy: Registration fees, less a $50 cancellation fee, are refundable if notice is received in writing by March 4, 2013 (five working days prior to the program). Refunds will not be made after that time. Payment:  Enclosed is my check for $ ____________ made payable to NAPHS.  Please charge my:  American Express  Visa*  MasterCard* *VISA/MASTERCARD HOLDERS: You must provide your three-digit CVV code, which can be found on the back of your card. AMERICAN EXPRESS: Provide four-digit code. ________ Account number: _________-_______-________-_________ Expiration date: ______________________________ Signature: ___________________________________________________________________________________

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