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AHM Coalition Town Hall Pre-Registration Form

Please complete this short form in its entirety in order to be re-directed to the registration for upcoming Town Hall.
1.Attendees have to enter only their legal First and Last name during event registration process in order to get PDA Points.(Required.)
2.Middle name(s) and/or professional designation(s) are Not ALLOWED in the First Name, Last Name Fields. Attendees who enters their middle name(s) and/or professional designation(s) or any other additional info WILL NOT receive certificates of completion for PDA Point(s).(Required.)
3.The NCBAHM ID# cannot contain any characters, letters or leading zeroes, it may have from 3 to 6 digits only.(Required.)
4.NCBAHM ID # can be easily found:

(Required.)
5.Attendees who do not have an NCBAHM ID# have to leave the NCBAHM ID# field blank(Required.)
6.Family and friends can watch the webinar presentation together but each of you have to be logged into the event's live session separately in order for each to receive PDA points.(Required.)
7.Certificates of completion are distributed via email within two weeks of event's date.(Required.)
Current Progress,
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