June 2022 Advanced Program

Infection Prevention & Control

Advanced Program

for Long-Term Care Facility

Infection Preventionists

Secure Online Event Registration

Shaping the Future of Infection Prevention

in Long-Term Care

June 3, 2020

8:30 am - 9:00 am - Registration

9:00 am - 4:00 pm

Hampton Inn & Suites

Burbank, California 91504

Location Information

Location Name
Hampton Inn & Suites
Address
7501 North Glenoaks Boulevard, Burbank, CA, 91504 US
Directions
Google, Bing, MapQuest

Participant Contact Information

Name*

Please include the type of license for your continuing education credits*

Do you have another license for which you would like CEUs?

Title/Position*

Title/Position*

Email*

Confirm Email*

I understand that all notifications regarding Boot Camp, including last minute changes, such as location, will be sent to this email address.

Please provide the best phone number where we can reach you in the event that there is a last-minute change in venue.

Phone Number - work*

Phone Number - cell

Facility*

Facility Parent Corporation*

Address*

Please indicate below whether you have received the COVID-19 vaccine. Thank you.

Please indicate whether you have received the COVID-19 vaccine.*

I received only the 1st dose of the COVID-19 vaccine
I have received both the 1st and 2nd doses of the COVID-19 vaccine
I have received at least one COVID-19 vaccine booster
I have not received the COVID-19 vaccine

Registration Information

Registration includes all course materials.

We regret to inform you that our rates will be increasing July 2022.

Registration Options*

Live In-Person ($299.00) [42 remaining]
Attend the 1-day course in person.
All course handouts will be included.
Lunch will be provided.

Vegetarian Lunch Requested

Please check if you would like a vegetarian lunch both days.

Running Total

$299.00

IPCR Reference

Total

$299.00

For a copy of our W-9 form, click the link this link: IPCR W-9 form.pdf

Or go to the registration page on our website at www.InfectionPreventionResources.com.

Cancellation Policy:*

No refunds will be given after May 27, 2022.
If you need to cancel prior to that date, please notify us and we will process your cancellation at the following refund rate:
Notification by May 13, 2022: 100% refund
Notification by May 27, 2022: 50% refund
Notification on or after May 27, 2022: no refund

This course may be live-streamed over the internet and recorded. I understand that if I am attending in-person I may be visible in the audience to those viewing the course on-line.

I have read and agree to the terms above.

Additional Information regarding cancellations or changes:*

Please note the following:
We recognize that circumstances arise such that you find you are unable to attend at the last minute. If that occurs, we cannot transfer your registration to another person but can send a coupon that can be used by another person to register. If this occurs on or after June 1, 2022, a $50 administrative fee will be applied.

I have read and agree to the terms above.

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