Outreach Programs

Student/Educator Seminar

Registration

To register send the following information and the registration fee to the address below before the registration deadline of March 16, 2012. Please place only one student or educator on each sheet submitted.

Registration Fee: $80.00 per student / $35 per Educator

Name: _______________________________________
Address: _____________________________________
City/State: ____________________________________
Phone: _______________________________________
E-mail: _______________________________________
RT Program Name: ______________________________
Indicate whether you are a Student or Educator: ___________________

Make Checks Payable to: University of Iowa Hospitals and Clinics.

You will receive a refund if registration is cancelled by March 23, 2012. Refer cancellations to Mary Huinker at (319) 356-3861 or mary-huinker@uiowa.edu.

Mail Registration and Registration Fee to: