Please complete the form below in order to register for:
Staten Island Care Center May 2024
Wednesday, May 8, 2024
5:00-8:30 pm
200 Lafayette Ave
* First Name:
* Last Name:
Please register with the same name that you have listed in the CE Registry.
* Email:
* Phone Number:
* License(s):
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
Type
CCM
LCSW
LMSW
LNHA
RN
other
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, DC
West Virginia
Wisconsin
Wyoming
Type
CCM
LCSW
LMSW
LNHA
RN
other
NAB ID:
Please provide your NAB ID which begins with the letter R and has seven digits following. If you do not have a NAB ID, please visit
nabweb.org
to create an ID.
* Facility Name:
* How many beds in your facility?
* Is your facility part of a group?
Yes
No
* What is the name of your group?
* Facility Type:
Hospital
Nursing Home
Other
IMPORTANT!
After you submit this page, you will receive an email with a link to confirm your reservation.
All uncomfirmed reservations will be cancelled.
By clicking the register button, you acknowledge that Signature Events does take photos/videos at events. These photos/videos might be used for marketing and promotional purposes.
