Maternal Fetal Medicine Professional Practice Continuing Education Series

note* : "For pdf of entire brochure, click on front cover of brochure."

REGISTRATION FORM
To register for this course,

Complete the form below and then click the "Register" button to send it to the Perinatal Cooperative.
Mail a check, payable to SNJPC, to:

Southern NJ Perinatal Cooperative
attn: Darlene Presson
2500 McClellan Ave., #250, Pennsauken, NJ 08109
856-665-6000 • (fax) 856-665-7711

Maternal Fetal Medicine Professional Practice Continuing Education Series
Feb 27, May 13, Sept 24, and Dec 3, 2008

            Name   

                    Preferred Mailing Address:

            Street  
              City   
             State    Zip 

        Home Phone  
        Work Phone  
               Fax  
            E-mail  

Agency/Institution  
             Title  


	
Check for Nursing Contact Hours


Specialty/Interest Areas (check all that apply)

Specialty		

Advance Practice
Cert Nurse Midwife
Office Nurse
Public Health
Other 

Interest Areas

Home Health Care
Obstetrics
Pediatrics
Other 

Please Select the Date of the Program You Plan to Attend

Wednesday, February 27, 2008 in Voorhees, NJ
Tuesday, May 13 in Mount Holly, NJ
Wednesday, Sept 24 in Voorhees, NJ
Wednesday, Dec 3 in Voorhees, NJ

Questions? Please Call the Perinatal cooperative at 856-665-6000.