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 REGISTRATION FORM
   2008 Newport EMS Conference

First Name         Last Name          Phone       

Address            Fax      

email              EMT Level    

City                    State          Zip       

Agency              Purchase Order  Number       

Address        

 Phone         

City                     State      Zip    

       
  Multiple Day workshops:  Register for Multiple Days ( register for individual days below)

 EMS Leaders Workshop  (Wednesday and Thursday)

 $ 200  

Paramedic Refresher 5 Days  (Wednesday-Sunday )

 $ 500  

Paramedic Refresher 3 Days (Wednesday - Friday )

 $ 360  

 EMD Refresher 2 Days (Wednesday - Thursday)

 $ 160  
  Wednesday workshops: April 2, 2008    

 EMS Leaders Workshop  (Wednesday Only)

 $ 90  

Paramedic Refresher- ( Adult Medical & Cardiac)   (Wednesday Only)

 $ 130  

 EMD Refresher  (Wednesday Only)

 $ 90  
  Thursday workshops: April 3, 2008    

 EMS Leaders Workshop  (Thursday Only)

 $ 130  

Paramedic Refresher- ( Pediatrics from A-Z)  (Thursday Only) 

 $ 130  

 EMD Refresher (Thursday Only)

 $ 90  

 Technology for Trainers   1 PM - 5 PM

 $ 80  

 Using the Field as a Classroom: Field Training Officer 8 AM - 12 PM

 $ 80  
  Friday  workshops: April 4, 2008    

ICLS:  8 AM - 5 PM

 $ 90  

Paramedic Refresher- (ALS Skills & Trauma)  (Friday Only)  8 AM - 5 PM

 $ 130  

CPR Renewal  8 AM - 12 PM

 $ 60  

Trauma Skills   8 AM - 12 PM

 $ 60  

Airway Management /AED   1 PM - 5 PM

 $  60  

MCI Management  1 PM - 5 PM

 $ 60  
  Conference   April 5-6, 2008  (saturday & sunday)    

 Conference

$ 140  

 Conference with Short Sleeve T-shirt    

$ 155 Size  
  Conference Clothing    

Additional Short Sleeve  T-Shirt: Gray

 $ 15 size  (S/M/L/XL. XXl)

Long Sleeve  T-Shirt: Gray

 $ 20 size  (S/M/L/XL. XXl)

Hooded Sweat-Shirt: Gray 

 $ 30 size  (S/M/L/XL. XXl)