training by correspondence pharmacology

Transcription

training by correspondence pharmacology
TRAINING BY CORRESPONDENCE
PHARMACOLOGY
REGISTRATION FORM
PERSONAL INFORMATION
Family name
First name
License no.
Address
City
Postal code
Telephone (home)
Email
COURSE TITLE
PRIX
TRAINING PROGRAM — PHARMACOLOGY
MEMBERS: $150.00
45 HOURS ON 90 DAYS
Please return this form with your payment
(cheque or money order) to the following address:
Ordre des infirmières et infirmiers auxiliaires du Québec
531, Sherbrooke St. East, Montreal (Quebec) H2L 1K2
Crédit card : Visa Mastercard
Card no.
Expiry date
Signature
COURSE FEES ARE NOT REFUNDABLE
PROGRAMME
DE
FORMATION
CONTINUE 2010
|
2011 CONTINUING
E D U C AT I O N
PROGRAM 1 

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