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To Register, please review meeting information:

Step 1 of 5

Enter your information into each field of the form.

Fields with * are required. Your email address will not be used for any other purpose than to communicate your registration information. It will not be given or sold to any other party, or used for any marketing activities.

First Name*
 MI
 Last Name*
       
Company* Title*
Department Type
Other
Address 1* Suite
Address 2
City*    
State/Prov Zip
Country*    
Work phone* Ext.
Fax Email*

Please choose your registration type*

Attendee
Speaker / Presenter

How would you like your name to appear on your badge?

First Name Last Name


Other Personal Information

Please check all that apply:
First time attending a "Quality Health Care for Culturally Diverse Populations" Conference
Vegetarian
Kosher
 
Please indicate any SPECIAL NEEDS (hearing, mobility, special meals, etc.) you may have, so arrangements can be made to enhance your participation at the conference:
 
Please enter a password:
Your email address and password can be used to return to this site and change your information, if necessary. Please keep your password in a safe place.

For Registration Questions: Jen Merkel, 602-265-8814 x 33
jmerkel@cmiresources.com
For Exhibit Info: Tatiana Reeves at 602-265-8814 x 35
TReeves@CMIResources.com
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