MDS Tomah - March 25, 2010
 

Attendance Intentions for RESCHEDULED MDS Innovation Team Meeting - March 25, 2010

 

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1. First Name

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2. Last Name

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3. E-mail Address

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4. Telephone Number

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5. Name of Organization

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6. Mailing Address

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7. City

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8. Zip Code

9. Please list additional participants (first & last name) from your facility attending the meeting.

In order to keep the fees at a minimum, WAHSA asks that you mail your payment directly to the WAHSA office. Please indicate on the check the name of the person(s) attending the meeting. If you cannot mail the payment in time, please make sure to bring a check, payable to WAHSA, to the meeting.

If circumstances arise and you're unable to attend this meeting, please call Sarah at the WAHSA office (608-255-7060) at least four days prior to the meeting to cancel.

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10. How will you be submitting payment?

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11. Do you plan on attending the MDS Innovation Team meeting scheduled from 9:00 a.m. to 3:00 p.m. (including lunch) at Holiday Inn - Tomah, 1017 East McCoy Blvd, Tomah, Wisconsin, on Thursday, March 25, 2010?