AZNHA Event Registration Form

Thank you for your Interest in participating in one of our educational programs.

If you have questions or need assistance with this form, please call Marie at 602-692-5315 or email the AZNHA Team at info@aznha.org.

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* Please select the program you would like to attend.

June 25, 2025: Home Care Leaders

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* Pricing Information:

AZNHA Members: $25

Board Guests: complimentary (enter the promo code in the space provided below)

Non-Members: $50/each

You will receive a link to pay the registration fee online.
Non-members: If your company applies for membership within 6 months after a program, you may request the $25 paid be applied towards the Annual Dues or a Attendee/Exhibitor registration (AZNHA Annual Conference).

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* Attendee Name

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* Company/Organization Name

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* Primary Role

Owner/CEO/Administrator

Client Care/Services

Care Provider

Marketing/Sales

Human Resources

Operations

Other (please specify)

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* Company Type

Home Care (In-home; non-medical)

Health Care (Hospice; Home Health; Nursing Care, etc)

Vendor (Service Provider)

Other (please specify)

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* Email

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* Phone number

Acknowledgement: By registering for this program you are providing Consent to AZNHA to share your name and contact information you have provided with the Presenter and/or Sponsor for this program.