Professional Development Day 2019 - Union City, TN

Union City, TN Professional Development Day
March 22, 2019

How many will be attending?
1 Attendee
Price: $30.00
(3 or more - $25 each) LATE REGISTRATION: After March 18, 2019 - $40
2 Attendees
Price: $60.00
3 Attendees
Price: $75.00
4 Attendees
Price: $100.00
5 Attendees
Price: $125.00
6 Attendees
Price: $150.00
7 Attendees
Price: $175.00
8 Attendees
Price: $200.00
9 Attendees
Price: $225.00
10 Attendees
Price: $250.00
Attendee #1
Name of Attendee #1*
First Last
Title of Attendee #1*
Company of Attendee #1*
Email of Attendee #1*
Phone of Attendee #1*
Attendee #2
Name of Attendee #2*
First Last
Title of Attendee #2*
Company of Attendee #2*
Email of Attendee #2*
Phone of Attendee #2*
Attendee #3
Name of Attendee #3*
First Last
Title of Attendee #3*
Company of Attendee #3*
Email of Attendee #3*
Phone of Attendee #3*
Attendee #4
Name of Attendee #4*
First Last
Title of Attendee #4*
Company of Attendee #4*
Phone of Attendee #4*
Email of Attendee #4*
Attendee #5
Name of Attendee #5*
First Last
Title of Attendee #5*
Company of Attendee #5*
Phone of Attendee #5*
Email of Attendee #5*
Attendee #6
Name of Attendee #6*
First Last
Title of Attendee #6*
Company of Attendee #6*
Phone of Attendee #6*
Email of Attendee #6*
Attendee #7
Name of Attendee #7*
First Last
Title of Attendee #7*
Company of Attendee #7*
Phone of Attendee #7*
Email of Attendee #7*
Attendee #8
Name of Attendee #8*
First Last
Title of Attendee #8*
Company of Attendee #8*
Phone of Attendee #8*
Email of Attendee #8*
Attendee #9
Name of Attendee #9*
First Last
Title of Attendee #9*
Company of Attendee #9*
Phone of Attendee #9*
Email of Attendee #9*
Attendee #10
Name of Attendee #10*
First Last
Title of Attendee #10*
Company of Attendee #10*
Phone of Attendee #10*
Email of Attendee #10*
Total
$0.00
A HealthWorks representative will be contacting you for payment information once registration is complete. (This is a non-profit event. Any excess proceeds will be donated to the Northwest Tennessee ASSP Scholarship Fund.)

REGISTRATION DEADLINE March 18, 2019
Please make sure and register by March 18, 2019 to ensure that we are ready for you!

COST: $30 per person
$25 per person if 3 or more from the same company
(Fee includes continental breakfast and lunch)

Late Registration Fee: $40 per person

Please make checks payable to HealthWorks.

Checks may be mailed to:
HealthWorks Medical
1720 East Reelfoot Ave, Suite 101
Union City, TN 38261
ATTN: Jennie Morehead

Questions Call: 731-599-1200 or 270-559-6580
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