9th National Lymphedema Network International Conference
Breaking through the Barriers: Research, Education, and Practice

Conference Registration

Registration will be accepted by fax, mail and online. No phone registrations will be taken. Fax/online registrations are for credit card payments only. Please send all check or money order registrations by postal mail to: 2010 NLN CONFERENCE SECRETARIAT, 1611 TELEGRAPH AVENUE, SUITE 1111, OAKLAND, CA 94612-2138.

Please make checks payable to "National Lymphedema Network" or "NLN." Payment must accompany the registration form. Registrations received without payment will not be processed and priority placement in Instructional Sessions will not apply until payment is received. Deadline for registrations by check/money order is September 1, 2010. Registrations by credit card will be accepted via fax/online through September 17, 2010.

CANCELLATION POLICY: Refund (less $30 administrative fee) only if cancellation is received on or before June 16, 2010.

1. Attendee Information

First Name:
Last Name:
Credentials:
(MD, PT, MT, etc...)
Institutional Affiliation:
Mailing Address:
City:
State:
Zip/Country Code:
Outside the US?
Country:
Daytime Phone:
Facsimile Number:
Email Address:
  Confirmation letter will be emailed to you within 1 week
Registrant Type:

Attendee
Faculty Member
Exhibitor Staff
LSAP

2. 2010 Conference List of Attendees

A list of attendees will be made available to participants of the 2010 NLN Conference. This will include participant's name, professional degree, address, telephone and email address. Please check the box below only if you do NOT wish to be listed.

I do not wish to be listed on the 2010 Conference Attendee List.

3. Special Needs  

Important: This section must be completed and submitted with your registration at least four weeks prior to the the conference.
Wheelchair seating accomodation
Hearing Device
Other:  

4. Wednesday Pre-Conference Seminars

Additional fee, $175 for 4-hour seminars, $250 for 8-hour seminars includes CME Certificate. Pre-registration required by July 15, 2010, as space is limited. Limit on-site registration available for additional $50 fee.

I will not be attending the Preconference Seminars.
[P1] Responding to Nonadherence and Preventing Personal Burnout - 1pm to 5pm
[P2] Wound Management in the Patient with Lymphedema - 9am to 5pm
[P3] Comprehensive Approach to the Morbidly Obese Patient with Lymphedema - 8:30am to 12:30pm
[P4] Physicians’ Intensive: Practical Management of Lymphedema and Related Lymphatic Disorders (MD, PhD, PA, NP, Medical Students only) - 10am to 5pm
[P5] Compression Bandaging Techniques: Review and Advanced Strategies - 9am to 5pm

5. Friday Instructional Session Choices

Choose one Instructional Session per line/per hour. See Schedule for titles and details of each session.

ATTENTION: Session H9 and H14 are titled Axillary Web Syndrome with and without Secondary Lymphedema.

IMPORTANT NOTE: Space is limited in these special sessions and placement is not guaranteed. Once filled, sessions will be closed. The NLN is not responsible for accommodating registrant requests once the Instrucational Sessions are filled.
08:00 AM
 H1 H2 H3 H4 H5
10:15 AM
 H6 H7 H8 H9 H10
01:30 PM
 H11 H12 H13 H14 H15
03:45 PM
 H16 H17 H18 H19 H20

6. Saturday Luncheon Choices

Preferred Choice (if available): Vegetarian Chicken Beef

7. Conference Registration Fees

 before April 9, 2010 after April 9, 2010
NLN Member*
membership number (required):
$500.00 $550.00
Non-Member
 $550.00 $600.00
 
Spouse/Guest
(Exhibit & Reception only)
 $75.00
Spouse/Guest's Name:
first
last  		$100.00
 
Pre-Conference Seminar
(select seminar above)
 $175.00 (4 hr)
$250.00 (8 hr)
* Your NLN Membership number appears on your NLN membership card/certificate, sent to all new and renewing members.

8. Payment Information

Please charge my: VISA  MasterCard  American Express  Discover
Charge Card Number:
Expiration Date: (00/00)
My Name: (acts as your signature)
Note:

9. Before Submitting

Before submitting, please review the cancellation policy above, and carefully check your information for accuracy.

Clicking the "Submit" button below confirms your acceptance of the cancellation policy outlined above.