Website of the Maine Hospice Council and Center for End-of-Life Care

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To register, complete this form and click 'Submit.' Space is limited, early registration is recommended.*

 

Individual Registration   

Individual registration fee: $129.00

Members registration fee: $116.00

Name:
Registration includes parking in the High Street parking garage which is attached to the Hotel. Space is not guaranteed -- please arrive early.

Group Registration

1 free for 5 paid  ($645.00 for group of six)

Group Members:

 

Additional Information

 
Organization (if representing):
Title:
Address Line One:
Address Line Two:
City, State, ZipCode:   
Daytime Phone:   Daytime phone number for questions.
Email: Registration confirmations are sent via email.
Special Requests:

 

Payment Information

 

Payment is expected at time of registration. On-line registrations will not be processed until payment is received.

Payment Method (check only one)    * required *

* required *

 

Registration/Cancellation Policy

 

Cancellations received on or before Oct. 1, 2008 will be charged a $15 cancellation fee. No refunds will be made for cancellations received on or after Oct. 1, 2008. Substitutions are allowed.

Please check this box to acknowledge understanding of our online registration and cancellation policy. If this box is not checked, your registration will not be processed.

 

Last Steps

Click 'Submit Registration' to send information to the Maine Hospice Council.  A page with your registration information will be displayed.

If paying with PayPal, click the 'Pay with PayPal' link on the Program page.


 

 

This site supported in part by funds from the Administration on Aging.

The Maine Hospice Council is a MaineShare Member Organization. For more information on workplace giving, please click here.

This page created by Al Hipkins using donated and low cost software and hardware. Please see our Acknowledgements page for a list of contributors and links to their sites.

Shipping: 693 Western Avenue, Manchester, Maine 04351
Mailing: PO Box 2239, Augusta, Maine, 04338-2239
Toll-free: (800) 438-5963  Local: (207) 626-0651  Fax: (207) 622-1274  
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