Transform Your Interdisciplinary Group… An Intensive Training for IDG Team Leaders, Clinical Managers and Team Facilitators

August 26-27, 2010
Charlotte Marriott Executive Park, Charlotte, NC


*First Name
*Last Name
*Title
*Agency Name
*Address
Address 2
*City
*State
*Zip Code
*Phone
*Email Address

OPTIONAL - 2nd Email Address: Use this field if you would like to receive the initial confirmation email at an additional address.

Registration Fee is $499 per attendee
Payment Method
If paying by credit card, Name on Card:
Billing Address (if different from above):
Credit Card Number:
Expiration Date:
Three digit security code on back of card:
If paying by PO number, please include number in this field.
ADA Requirements
Comments