Name:
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Contact Information:
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*Email address:   Required Invalid email address

Your Organizations Information:
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*Category:  PhysicianNursePublic HealthOther MedicalDoH EmployeeOther Required

Mailing Address:
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*I will be attending:In PersonVideo ConferenceTeleconferenceWebcast Required
If attending via video conference please specify conference room location:

Course Information:
Name of course:  Emergency Medical Responders role during an Influenza Pandemic, Series of four classes on, 3/17, 4/21, 5/19, and 6/16 2009
Course location:  Bismarck
Course starting date:  3/17/2009

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