International Transplant Nurses Society
 
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ITNS Symposium Registration Form

[For printableprint version, download Symposium Registration (PDF) and mail in your check via U.S. Mail]

First Name:

 

Last Name:

 

Degree / Credentials:

 

Position / Role:

 

Employer:

Employer Address:

Preferred Mailing Address:

Home Work

 

Preferred Email Address:

 

Mailing Address:

 

City:

   

State/Province:

   

Postal Code:

Country:

Phone Number:

   

Fax Number:

   

WORKSHOP SELECTION:
There are 8 half day workshops. Please select one option for the morning and one option for the afternoon.

Morning Workshop Options (Select ONLY ONE)

Putting It All Together: Integrating Complementary Therapies into Your Transplant Practice
Health Literacy: Instant Teaching Tools for Diverse Learners
The High Risk Transplant: Identifying Those at Risk, Risk Stratification and Management Strageties
The Other Side of Transplant: The Donor World

Afternoon Workshop Options (Select ONLY ONE)

Heart and Lung Transplant: The Future is Now
Research and Evidence Based Practice
Staff Nurse: Practice Enrichment Through Knowledge and Interaction
Issues with Aging Recipients

SIG / COMMITTEE / CHAPTER LEADERS MEETINGS:

APN Cardiothoracic Chapter Leaders Education Research Staff Nurse Pediatrics ITNS Past Presidents

I will attend the Lunch Thursday Friday Saturday

I will attend the Welcome Reception on Wednesday, October 27, from 5:30 pm - 7:30 pm. The Symposium begins Thursday, October 28.
Yes No -- (no charge/fee)

I will attend the Poster Session / Wine Reception on Friday, October 29 from 4:45 pm - 6:00 pm
Yes No -- (no charge/fee)

I would like to serve as a Moderator for an abstract breakout session?
Yes No

Is this your first ITNS Symposium?
Yes No

Kidney / Pancreas Heart / Lung Liver Small Bowel Research QOL Procurement Pediatrics Donor
Other

Staff Advanced Practice Transplant Coordinator Manager/Administrator

SYMPOSIUM REGISTRATION:

 

$500 ITNS Member Rate

ITNS #

 

$575 Non-Member Rate

Not a Member Yet? If you would like to join ITNS today, for no additional fee, please complete the membership application at ITNS Become A Member -- DO NOT process a payment for an additional $75 via Google Checkout.

ONE DAY REGISTRATION:

I plan to attend: Thursday Friday Saturday

$175 ITNS Member Rate

ITNS #

$250 Non-Member Rate

Not a Member Yet? If you would like to join ITNS today, for no additional fee, please complete the membership application at ITNS Become A Member -- DO NOT process a payment for an additional $75 via Google Checkout.

 
 
               
 
     


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