To register for the 2008 Community Health Interactive, please complete the following information:

 

Contact Information.

First Name:
Last Name:
Title:
Organization:
Street Address:
Street Address 2:
City:
State:
ZIP:
Phone:
E-mail:
Sector. Choose one option which best reflects the group you represent. Business Education Faith Government Healthcare Other Civic / Community Organization Community Member
Lunch.   A boxed lunch will be provided at the event. I prefer a vegetarian option.

form version 2

Don't forget the date:

Wednesday, April 16, 2008

9:00 a.m. - 1 p.m.

Chelsea Center

Registration will open at

8:30 a.m. on April 16th.

Morning coffee and lunch

will be provided.