REGISTRATION FORM

The NRLI Issues Forum

for New Rehabilitation Executives

August 6-8, 2008
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, 2008

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.

Current Resume/Vita

Applicants should include an updated copy of their vita with the registration. The vita should include prior and current work and educational experiences.

 Please attach your vita and send via E-mail to:

sdavis@interwork.sdsu.edu

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 2008

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

Credit cards: 

If you wish to use a credit card, please send your email request to John Summerfruit.  Be sure to include your daytime telephone number. [Do not provide any further information at this time.]

summerfr@mail.sdsu.edu

Be ready to provide the following information:

• your full name and address as it appears on the credit card
• name of credit card company (Visa, Master Card, etc.)
• credit card number
• the expiration date
• your billing address

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