PACE ATTENDANCE ROSTER MIH User Group Webinar

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* 1. INSTRUCTIONS: Each webinar attendee must complete the information below to receive PACE, California or Florida CE or a Certificate of Attendance.

Date of Webinar: January 31, 2017

Speakers:
Monica Kalvelage, MT(ASCP)MB, SBB
LifeShare Blood Centers

Katrina Billingsley, MT(ASCP)SBBCM
LifeShare Blood Centers

Jules Zinni, MLS(ASCP)CMMBCM
Northwestern Memorial Hospital

Trina Horn, MS MLT(ASCP) SBBCM
Jessica Keller, MS MB(ASCP)CM
American Red Cross National Molecular Laboratory

PACE Program#: 437-302-17
Florida Program #: 20-585936

Contact Hours: 1.0 hours

Location: Webinar
Coordinator: Dickie Nichols

First Name: *

Last Name: *

Facility Name: *

Address

City/Town: *

State/Province: *

Postal Code: *

Country:

Email Address: *

Phone Number:

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* 2. Confirm Email Address:

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* 3. Immucor Customer Number:

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* 4. Please indicate which type of continuing education credits you would like to receive for this educational program.

ASCLS/P.A.C.E.

California

Florida

Certificate of Attendance only