Leading Home Care
The Academy for Private Duty Home Care
Seattle, WA
April 8, 2010

The Academy for Private Duty Home Care
Want to Mail Form?

If you are a HCAW member, please register by clicking on this link

REGISTRATION FEES:
**** $399 per person Registration Fee
**** Register a second attendee and receive a $50 discount

Registrations must be received by March 18, 2010.
 

ATTENDEE INFORMATION
 
* indicates required
* First Name:
* Last Name:
* Company Name:
* Job Title:
  Mailing Address
* Address:
* City:
* State:
* Zip:
* Phone #: (Numbers Only)
Alternate Phone #: (Numbers Only)
Fax #:
* Email:
 

HOTEL ACCOMMODATIONS:
  To reserve a room for this event, please click on the following link. Or call Wendi Lynagh with Home Care Association of Washington at 425-775-8120.
 

CONFERENCE REGISTRATION PAYMENT:
* Please select a payment type:  
     My check is enclosed (made payable to Visitours)
     Visa   Master Card   Discover   American Express  
* Cardholder Name:
* Card Number:
* Expiration Date:
* Security Code:

 

The security numbers that we ask for are the numbers printed on the back of your credit card on the signature strip, towards the top and right of the strip (please see the picture below). There are between three and ten digits. We only require the last three.

Mastercard & Visa have introduced this system to provide greater levels of security to protect the customer. The security numbers are separate from the embossed numbers and from those contained in the magnetic strip. This means that you need to have the physical card to know the number.
Total Registration:
$399.00


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