AANA #

Affiliation/Facility

First Name

Last Name

Street Address 1

Street Address 2

City

State

Zip

Email Address

Phone Number

Please select one of the following:
Full Program Early Registration (register by November 2nd) - $300.00
Full Program (all registrations after November 2nd) - $325.00
Friday - $75.00
Saturday (AM only) - $100.00
Saturday (Full Day with Workshop) - $250.00
Sunday - $75.00
***You may also register and pay online at http://www.oregon-crna.org

Payment Information
Mail check with registration receipt to:
Oregon Association of Nurse Anesthetists
PO Box 4444
Salem, OR 97302

Refund Information
Full refund less $25.00 handling fee up to November 1, 2008. No refunds after November 1, 2008.

Accommodation Information
Please contact the hotel directly to book your room:
Hilton Executive Tower
921 SW Sixth Avenue
Portland, Oregon 97204

Tel: 1-503-226-1611
Fax: 1-503-220-2565

***The reduced conference rate is $145 plus tax