Registration Form

2015 Annual UPCRA Spring Conference
April 27-28, Bismarck, ND
Registration includes CEU’s. Please check one:
Members-----$115
Non-Members-----$150 (1 yr UPCRA membership included)
Make checks payable to: UPCRA
Student-----$55
Fee is non-refundable
Note: UPCRA membership is $25 per year and covers June 1st to May 31st of the following year. Membership dues
for June 1, 2015 – May 31, 2016 will be due April 30, 2015 and can be mailed at any time to Laura Fitzgerald, the
membership
chair. If you are already a 2014/15 member, please check the Member registration box for the
discounted amount. If you are not a current member, please check the Non-Member registration box which will
provide you with an UPCRA membership from the UPRCA Spring Conference through May 31, 2016.
**If interested in becoming an UPCRA member or if you have questions about membership please contact:
Laura Fitzgerald, membership chair at lfitzgeral@regionalhealth.com or call 605-755-8045
Mail registration to:
Heart of America Medical Center
Attn: Karen Drader, Cardiac Rehab
800 Main Ave. S
Rugby, ND 58368
Deadline:
Mail in registration by
April 15, 2015
Questions:
Laura Fitzgerald
605-755-8045 or
lfitzgeral@regionalhealth.com
(Please Print Clearly)
Name______________________________________________________
Title________________________________
Work Phone_______________________________ E-mail__________________________________________________
Organization______________________________________________________________________________________
Work Mailing Address_______________________________________________________________________________
We will be doing all correspondence (including Conference PowerPoint Notes) via email and the website, so please check them often. Are you a member of: AACVPR (American Association of Cardiovascular and Pulmonary Rehabilitation) ACSM (American College of Sport Medicine) Local Chapter of ACSM At the time of printing this brochure, this program is being reviewed by the American Association of Cardiovascular and Pulmonary Rehabilitation Education Committee. AACVPR credit may be accepted by various licensing agencies. While programs may be pre‐approved for CE credit in a given state, please check with your individual state for specific requirements. Please check box if you need a CEU certificate Please choose one from each of the following: Tuesday, April 28, 9:00 am Cardiac Tract: “Introduction to Device Therapy: Cardiac Disease Management” Tuesday, April 28, 10:30 am Cardiac Tract: “Protecting Your Patient at Risk for Sudden Cardiac Arrest” Pulmonary Tract: “Putting Guidelines into Practice” Pulmonary Tract: “Understanding COPD – Recent Research & the Evolving Definition of COPD”