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Thank you for taking the time to register for Disney's Approach to Quality Service for Healthcare Professionals. Indicate which program you wish to attend by selecting the box next to the program date.


Disney's Approach to Quality Service for Healthcare Professionals - DAQSHP

Click Here for Program Details and Agenda

DAQSHP: December 14-17, 2008
      Held at Disney's Yacht Club Resort

  DAQSHP: April 1-4, 2009
      Held at Disney's Yacht Club Resort

  DAQSHP: August 23-26, 2009
      Held at Disney's Yacht Club Resort

Please fill out the following Registration information.
Required Fields are indicated by a star: If non-applicable, type N/A.

Mr. Mrs. Miss. Ms. 

Name

Title
Company Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

NOTE: If you wish to have the invoice sent to a different address/person, please enter their contact information below. Their Name, Address and Phone number if different from the above, and their Email address must be included.

Alternate Contact Information


Please list any dietary requirements, room preferences and preferred method of contact       (e-mail-fax, etc) in the box below. You may also request Additional Room Nights and   Disney Park HopperŪ Passes here.

Diet / Preferences / Additions / Comments / Questions?



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