EARN 1.5 FREE CEUs at the

SENIOR RESOURCE FAIR for SOCIAL WORKERS, CASE MANAGERS, & DISCHARGE PLANNERS

Wednesday, May 15, 2013Slidell Memorial Hospital

Founder’s Building1150 Robert Blvd, Slidell

5:00pm - 7:00pm

REGISTRATION FORM FOR SOCIAL WORKERS, CASE MANAGERS & DISCHARGE PLANNERS

First Name:       Last Name:      

Company Name:       Position:      

Address:      

City:       State:       Zip:      

Business Phone:       Personal Phone:      

Email Address (required):      

Will you be able to attend the event? Yes No

NASW Member? Yes No

Please fill in the form above, save to your computer and email as an attachment to Serra Wobbema at serra.wobbema@hotmail.com by Tuesday, May 14, 2013.