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(Information received after June 1, 2011 an additional fee of $10.00 will be added.)
MoSALPN Registration and Awards Luncheon . . . . . . . . . . . . . $100.00 _________
(LPN and Sustaining Members)
Registration and Awards Luncheon . . . . . . . . . . . . . . . . . . . . . . . . $85.00 _________
(Associate Member 65 and over)
Registration and Awards Luncheon . . . . . . . . . . . . . . . . . . . . . . . $125.00 _________
(Non-MoSALPN Member)
Awards Luncheon Guest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25.00 _________
Total amount enclosed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________
Name ___________________________________________________________
Address _________________________ Phone (____)_______________
City, State, Zip _________________________________________________
Cancellation Notice: Upon receipt of a written request MoSALPN will issue your registration fee less a $25.00 processing fee, if received before June 4, 2011.
Student Registration will be sent to the school.
Mail payment to:
MoSALPN
P.O. Box 105542
Jefferson City, MO 65110
ROOM RESERVATIONS MUST BE MADE THROUGH HOTEL
Holiday Inn Kansas City
SE Waterpark Hotel
9103 E. 39th St.
Kansas City, MO 64133
816-737-4725
If you should encounter any problems, call the State Office and let us know. We will stay with this program unless we have a problem with the speaker's schedule.