Continuing Education
Diabetes Education Certificate Program
Registration FormSeptember 21-24, 1999
Radisson Airport Hotel, 2081 Post Road, Warwick, RI 02886
Name _____________________________________________
Address ___________________________________________ City _______________________ State _______ Zip ________ Phone _____________________ Fax ____________________ Practice Location: __________________________________________________ Fee: $495.00 on or before September 1, 1999 $550.00 after September 1, 1999 Make check payable to: URI College of Pharmacy CE and please return this form and check to: URI College of Pharmacy, Office of Continuing Education, 41 Lower College Rd., Rm. 105, Kingston, RI 02881-1966 Visa or Mastercard # ________________________ Expiration Date: ________________ Registration: The registration fee for the four-day course is $495 per person if received on or before 9/l/99. The late registration fee is $550 if received after 9/1/99. This fee includes all program materials, luncheons, coffee breaks, and Friday reception. Program limited to first 30 registrants. Register now. Call the URI Office of Pharmacy CE at (401) 874-5552 for further information. Refund/Cancellation Policy: Costs of conducting the program increase closer to the program date. Cancellation on or before September 10 is subject to a $25 processing fee. Cancellation after September 10 is subject to a $200 processing fee. All cancellation requests must be received in writing. No refunds will be issued for non-attendance. Target Audience: Community, hospital, managed care and and consultant pharmacists and other interested health care professionals. This certificate program is a prerequisite for pharmacists planning to apply for certification as a Diabetes Outpatient Educator by the Rhode Island Department of Health. | 
