Registration

Registration Information

Early Registration: $400 (until March 31, 2008)
Late Registration: $450 (between April 1, 2008 and May 5, 2008)

Fax: 423-439-8267
Phone: 423-439-8084 or 1-800-222-3878
Mailing Address:

East Tennessee State University
Office of Professional Development, Box 70559
Johnson City, TN 37614

First Name
Last Name
Affiliation or Company

Street Address

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State
Country
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Home Phone / Fax
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SSN

Choice of Courses
	Evidence-Based Practice for Rural Public Health (FULL)
	GIS and Public Health *
	Genetic Epidemiology
	Stroke Epidemiology *
	* Limited enrolled, see Courses for details

Are you interested in participating in a recreational activity on? Options will be available, depending on interest shown.	Tuesday Hiking on Roan Mountain $15.00 includes lunch Lunch and Shopping $15.00 Golf and lunch $45.00 Thursday Whitewater Rafting $46.00 does not include lunch Lunch and Shopping $15.00 Golf and lunch $45.00 Saturday (tba)

Lodging Options	I will make my own lodging arrangements
	ETSU On-Campus housing

Payment Options	Credit Card
	Mail check
	Invoice organization

Card Type
Card Number / PO
Expiration Date
Name on Card
Department Name

Whitewater Rafting on the Nolichucky River