Professional Development Registration Form
Secure

Notes:


Personal Information

Items with an asterisk (*) are required.

  (Area Code)   Telephone Number
( )     Ext:
( )  
Other Information
If you are registering for Prescription and Management of Controlled Drugs and Substances, please indicate the jurisdiction in which you are registered as a Nurse Practitioner and your RN Registration Number.

Jurisdiction:

RN Registration Number:

Online Course Information

Once your payment has been accepted, an email will be sent to you using the email address you provided on this form. The email will include information to access the course(s). Please ensure that your email address is accurate and that emails sent from @athabascau.ca will not end up in your spam folder.

You will have access to online course(s) for six months from the day of registration. Once you have successfully completed the online course(s), you will be able to download and print certificate(s) for your records.

On-site Workshop/Seminar Information

For on-site workshop information, please refer to the description of your workshop(s)/seminar(s) on the Faculty of Health Disciplines Professional Development web pages.

Selection and Fees

Please select your course(s), workshop(s) and/or seminar(s) below (all registration fees are subject to 5% GST):

Narcotics Modules
C$169
Mental Health Modules
C$200
C$200
Counselling
Listening for Openings, Amplifying Change
Solution-Focused Brief Therapy 5-Day Intensive Workshop (on-site)
July 11-15, 2018 - Mount Royal University, Calgary

Note: Spaces are limited.
Registration refundable through June 26, 2018.
C$800
C$700
C$550
Payment Method

Credit card payment

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Your information is transmitted through a secure connection.

The personal information collected on this form will be used to process your request and is collected under the authority of section 33 © of the Alberta Freedom of Information and Protection of Privacy Act.