Course Registration Call for registration price or submit this form to obtain more information. Pricing varies per state and program. We will email or call you with pricing.   Cancellation/Refund policy: All cancellations must be made at least 14 days prior to start of program. A $100.00 administrative fee will be charged for all cancellations and refunds. Non-attendance leads to forfeit of all monies or registrant must attend another seminar. A return check fee of $25.00 will be charge.   First Name * Required Last Name * Required Street: * Required City: * Required State:   ---USA--- AK AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY * Required Zip: * Required 5 digit E-mail: * Required Work Phone: * Required include area code Home Phone: * Required include area code Location: * Required Date: * Required Number of Registrants: * Required Choose Program: Select Program Hemodialysis Training Peripheral IV Wound/Skin Care Code Blue The prices vary from state to state, we will contact you with the total for your registration and confirm before your card is charged.   Credit Card: Visa MasterCard American Express   Number: Exp. Date: Month 1 2 3 4 5 6 7 8 9 10 11 12 Year 2009 2010 2011 2012 2013 2014 2015 2016 Security Code: 3 digit code on back of card