marcus evans : National Healthcare CNO Summit Spring 2011
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Register your interest


  National Healthcare CNO Summit Spring 2011
 25-27 May 2011, The Westin Diplomat Resort & Spa, Hollywood, FL, USA
 Travel Form

This form is solely for attendees whose participation has been confirmed at the summit.
If you have any questions regarding participating at the summit, please email lee-anner@marcusevansbb.com

*Where indicated, field must be completed so that the form will be successfully sent to the Event Manager.
Personal Details
Please note that the information you give below will be used to create your name badge.
*Full Name
*Job Title
*Company
*Mobile  
*Email  
Transport Details

Summit begins 25 May 2011 at 12:00      Summit ends 27 May 2011 at 12:30

Please allow for relevant travel time from your country on departure and arrival to ensure you are at the hotel for the beginning and the end of the Summit.

CLICK THE RELEVANT SECTION BELOW TO CONFIRM METHOD OF TRANSPORT
Air
Rail
Car
ACCOMMODATION:
marcus evans summits has reserved complimentary accommodation for single occupancy for the first and second nights of the summit.
I need accommodation I do not need accommodation
Please complete to ensure a room is booked for you accordingly.

Please indicate if you would prefer to reserve a room in which you may smoke:

A number of rooms are available within the Hotel for guests with disabilities. Please advise if you have any special needs:

Additional Nights Accommodation:
If you require additional accommodation outside the first and second nights of the summit, please complete the below section.

All bookings for extra nights accommodation are subject to availability and at your own expense. You must ensure that any additional personal expenses, including additional accommodation, are settled in full before departing the hotel.
I need additional accommodation        I do not need additional accommodation
Visa Requirements
If you require a visa to enter USA please complete:
I require a visa
Catering Requirements

Please advise if you have any special requirements (e.g. vegetarian, lactose free etc.)

Additional Comments

Please advise if you have any additional comments

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