DISTANCE TRAINING PHARMACOLOgy
Transcription
DISTANCE TRAINING PHARMACOLOgy
DISTANCE TRAINING PHARMACOLOGy REGISTRATION FORM PERSONAL INFORMATION Family nameFirst name Licende no.Address City Postal code Telephone (home)Email course Title Prix Training PROGRAM — PHARMACOLOGy 45 hours 125,00 $ Please return this form with your payment (cheque or money order) to the following address: Ordre des infirmières et infirmiers auxiliaires du Québec c/o Nicole Bélanger 531, Sherbrooke St. East, Montreal (Quebec) H2L 1K2 Fax : 514 282-0693 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