ANNUAL INSTITUTE ON MEDICINE & RELIGION


REGISTRATION

The 53rd Institute on Medicine and Religion:
THE NATURE FIX (CHE344)
November 1, 2019 8:30AM-4:00PM

Please contact WMHS at the phone number below for any questions. To Register on-line fill out this form and be prepared to pay through PayPal. Registration by telephone is NOT available. To register via postal mail complete the form found HERE and mail with a check to:

Professional Development Department
Western Maryland Health System
12500 Willowbrook Rd
Cumberland, MD 21502
240-964-8500
Name:
Address:
City:
State:
Zip Code:
Email Address:
Phone:

CONTINUING EDUCATION UNITS

CHECK TYPE OF CREDIT YOU ARE SEEKING:*
Nursing
Counselors
Clergy
C.M.E.
Psychology
Social Work
Other
Dietitians

(Receives ACM Certificate of Completion)

Are you taking this for: (Mark one):*
Work / Professional
Personal Development

Course Cost: $59.00 includes morning refreshments, lunch and a copy of THE NATURE FIX.

Register By: October 25th, 2019



If paying by check please make checks payable to WMHS and attach the filled out printable version of this form found HERE.

Allegany College of Maryland does not discriminate against any individual for reasons of race, ethnicity, color, sex, religion or creed, sexual orientation, gender identity or expression, national origin, age, genetic information, familial status, disability or veteran status in the admission and treatment of students, educational programs and activities, scholarship and loan programs, or to terms and conditions of employment, including but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation and training. Allegany College of Maryland complies with applicable state and federal laws and regulations prohibiting discrimination and Maryland prohibits retaliation in any form against any person who reports discrimination or who participates in an investigation.