Shaping and influencing health care
within the Department of Veterans Affairs


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NOVA 28th ANNUAL MEETING
REGISTRATION FORM
Note: Each participant must fill out a separate registration form.

To receive the discounted Pre-Registration fee, registration form must be submitted by 2/09/08. There will be no refunds after 3/18/08. Cancellations prior to this date will be charged a $25 processing fee. Cancellations must be in writing.

Filter Type:
Email Address:
Participant Name:
Name For Badge:
Spouse/Guest Name:
Spouse/Guest Name for Badge:
VA Facility:
Your Home Address:
City, State, Zip:
Daytime Phone:
FAX Number:
Registration Rates
Please check all that apply.
 $310 NOVA Member - before 2/09/08
 $330 NOVA Member - after 2/09/08
 $425 Non-Member - before2/09/08
 $425 Non-Member - after 2/09/08
 $125 Spouse/Guest (Non-VA employee)
 $175 Daily Registration (no CEU's)
 $195 NOVA Retiree Registration
 $50 NOVA Foundation Reception & Auction
 $40 Theater Show "Menopause"


MEMBERSHIP:
Yes, I would like to support my professional organization for an annual membership fee of $100.
 I would like to join NOVA  Please renew my membership


NOVA FOUNDATION:
I would like to support the NOVA Foundation with a donation in the amount of:
 $10  $25  $50  $100  $250
TRAVEL AND HOTEL INFORMATION
Official Hotel:
Radisson Boston Hotel
200 Stuart Street
Boston, Massachusetts

Room Rate: $189.00 Single/Double
Reservation Cut Off: March 18, 2008
Call Hotel Direct for Reservations at: 617-482-1800
???QUESTIONS???
Phone: 202-296-0888 -- Fax: 202-833-1577
Or, enter your comments in the box below:
Submit your Registration by clicking this button:


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For more information:
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1726 M Street, NW, Suite 1101
Washington, DC 20036 US
202-296-0888
Fax: 202-833-1577

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