November 1-3, 2006 HSLI Annual Conference Registration ______________________________________________________________________________ Complete one form per registrant First Name:______________________ Last Name:______________________________ Institution:_______________________________Library:_________________________ Address:___________________________City/State/Zip:_________________________ E-mail:__________________________________ Phone #:________________________ Fees: (Full Conference fee includes: Meeting registration, breakfast & lunch on Thursday & Friday, Nancy’s Reception and CE courses) HSLI Member $150 ___________ (3 days) Nonmember $175 ___________ (3 days) Students $85 ___________ (3 days) Thursday Only $125 ___________ (includes Thur. meals, CE classes & Nancy’s Reception Friday Only $75 ___________ (includes Fri. meals, Keynote Address & Business meeting) Nancy’s Reception guest $45 ___________ (for additional guest only) Late Fee (additional) $25 ___________ (after October 1st) _______________ Total Amount Enclosed ______ Attending Individual Consortium meeting Wednesday 1-3 from which consortium?_____________________ ______ Check here if you plan to come to the Wednesday Future of Consortia meeting 3:30-5. To register for continuing education courses, check the appropriate lines. See continuing education descriptions on the Conference website at http://hsli.org/Conference/ _________ Creating Online Training Using Little or No Money – Scott Garrison MLA CE (4 hrs.), Thursday, Nov. 2 / 8 am—12 pm _________ Getting Magnetized – Search and Service Strategies for Nursing Excellence – Peg Allen MLA CE (4 hrs.), Thursday, Nov. 2 / 1 pm—5 pm _______ Health Sciences Librarians and Patient Safety: understanding leadership roles, reliability and failure – Lorri Zipperer & Linda Williams MLA CE (4 hrs.), Thursday, Nov. 2 / 8 am—12 pm _______ Patient Safety Resource Seminar: Librarians on the Front Lines – Holly Burt MLA CE (4 hrs.), Thursday, Nov. 2 / 1 pm—5 pm ______ Check here if you plan to attend the Nancy’s Reception and Dinner at the Spring Valley Nature Center, Thursday, November 2 from 6:00pm-9:00pm _______ I will need a ride from the hotel to the Nature Center (car pooling encouraged) _______ Vegetarian Meals Make your check payable to HSLI and mail it with this completed form to: Dalia Kleinmuntz – HSLI 2006 Webster Library Evanston Northwestern Healthcare 2650 Ridge Ave. Evanston, IL 60201 Email: webster@enh.org Phone: 847-570-2665 Fax: 847-570-2926 |