GPIN Group Practice Improvement Network

Registration Form

Please submit by September 25, 2008
First Name
Last Name
Degree (DO, MD, PhD, RN, etc.)
Title
Organization
Address
Address 2
City
State
Zip Code
Telephone
E-Mail (Required):
First Name for Badge:

This is my 1^st time attending a GPIN meeting.


Wednesday, October 15th - Welcome Lunch; 12:00 - 1:00 pm
Yes, I plan to attend.	No, I will not attend.
Wednesday, October 15th - Reception; 5:30 - 7:30 pm
Yes, I plan to attend.	No, I will not attend.
Thursday, October 16th - Reception/Dinner @ Dona Emilia's Bar & Grill, 6:30 - 9:00 pm
Yes, I plan to attend.	No, I will not attend.
Friday, October 17th - Lunch; 12:00 noon - 1:00 pm (Following conference adjournment)
Yes, I plan to attend.	No, I will not attend.
Please click the Submit button below to register for this conference and view payment options.

1 Ford Place, 3B • Detroit, Michigan 48202
Phone: (313) 874-GPIN (4746) Fax: (313) 874-4389 e-mail: info@gpin.org

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