REGISTRATION FORM

The NRLI Issues Forum

for New Rehabilitation Executives

August 4-6, 2010
The George Washington University

Registration Procedure

The National Rehabilitation Leadership Institute (NRLI) accepts both electronic and paper registrations for the Issues Forum.

Registration deadline:   July 9, 2010

Click here for Paper Registration

Click here for Electronic version

Registration Fee:  $200

* (Payable to the NRLI Forum upon registration confirmation.)

Applicants will receive registration confirmation from Sharon Davis at San Diego State University

Please make checks or purchase orders payable to:

Interwork Institute/NRLI Forum 2010

SDSU Research Foundation

Note:  It is important that you reference the payment to the name of the participant who is attending the Forum to assure that proper credit is given; otherwise, registration confirmation may be delayed.

Purchase orders may be faxed to John Summerfruit at 619 594-4208.  Questions regarding PO's may be emailed to John Summerfruit at:

summerfr@mail.sdsu.edu

Please mail payment to:

Interwork Institute/NRLI

San Diego State University

Attention: John Summerfruit

3590 Camino del Rio North

San Diego, CA  92108-1716

Special Accommodations

If you require any accommodations, please complete the Special Accommodations section of the electronic Registration form below.   To ensure your full participation, please provide the necessary information to the NRLI at least 20 days prior to the activity so that appropriate arrangements may be made.

Questions

If you have any questions regarding the registration form or registration deadline, please contact the NRLI at:

National Rehabilitation Leadership Institute
San Diego State University
Attention:  Sharon Davis
3590 Camino del Rio North
San Diego, CA  92108
Phone: 619-594-4220
Fax: 619-594-4208
E-mail:  sdavis@interwork.sdsu.edu