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REGISTRATION FORM

 

The NRLI Issues Forum

for New Rehabilitation Executives

August 2-4, 2010
The George Washington University

Registration Procedure

The National Rehabilitation Leadership Institute (NRLI) accepts both electronic and paper registrations for those seeking admission to the Issues Forum.

Registration deadline:   June 15, 2010

Please read the following information carefully to determine the materials needed for registration.

Click here for Paper Registration

Click here for Electronic version

Registration forms should be submitted by the published deadline date.

Admission

Applicants will receive registration confirmation from Sharon Davis at San Diego State University

Registration Fee

$200 *

* (Payable to the NRLI Forum upon registration confirmation.)

Important: 

It is important that you reference the payment to the name of the participant who is attending the Forum to assure that proper credit is given; otherwise, registration confirmation may be delayed.

 

Please make checks or purchase orders payable to:

Interwork Institute/NRLI Forum 2010

SDSU Research Foundation

Please mail payment to:

Interwork Institute/NRLI

San Diego State University

Attention: John Summerfruit

3590 Camino del Rio North

San Diego, CA  92108-1716

 

Purchase orders may be faxed to John Summerfruit at 619 594-4208.  Questions regarding PO's may be emailed to John Summerfruit at:

summerfr@mail.sdsu.edu

 

Special Accommodations

If you require any accommodations to ensure your full participation please provide the necessary information to the NRLI at least 20 days prior to the activity so that appropriate arrangements may be made.

Questions

If you have any questions regarding the registration form or registration deadline, please contact the NRLI at:

National Rehabilitation Leadership Institute
San Diego State University
Attention:  Sharon Davis
3590 Camino del Rio North
San Diego, CA  92108
Phone: 619-594-4220
Fax: 619-594-4208
E-mail:  sdavis@interwork.sdsu.edu


Electronic Registration for

NRLI Issues Forum for New Rehabilitation Executives

* - required fields


 

Special Accommodations requested: (please specify):


 

General Information:











Statement of Agreement

By entering your name, you agree to attend the Forum of the NRLI (must match with name provided above)


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