RESOLVE of the Bay State



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Peer Discussion Groups

Topic Discussion Groups

Upcoming Programs:

Elective Single Embryo Transfer (eSET)
Tuesday,
July 27, 2010
6:30 - 8:30 p.m.

Getting the Most from
Your Infertility Insurance Coverage
Wednesday,
September 22, 2010
7:00 - 9:00 p.m.

The RESOLVE Fertility Treatment,
Donor Choices, and Adoption Conference

November 7, 2009
Best Western Royal Plaza Hotel
Marlborough, MA

REGISTRATION FORM
(Please enter your information in the spaces provided, print out the form, and fax or mail as directed below in Step 7. Or, register now online)

STEP 1: Attendee Information
Name:
Name2:
Addl Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
STEP 2: Membership
	If you are not yet a member, join now and save on registration fees:
	$55 - Individual or Household Member
	$150 - Professional Member
STEP 3: Registration - Choose one of the following options:
Standard Registration - Continental breakfast and lunch included with registration. Fees through Thurs., Nov. 5, 2009 at 5 PM
Non- members	$185 – Individual			$350 – Couple
RESOLVE members	$115 – Individual			$199 – Couple
Family & Friends	$70 per person for 3rd person
Scholarships Available*
Walk-In Registration - Received after Nov. 5, 2009. Lunch is not guaranteed
Non- members	$205 – Individual			$390 - Couple
RESOLVE members	$135 – Individual			$239 – Couple
Family & Friends	$90 per person for 3rd person

STEP 4: Continuing Education Credits
7.2 hours for nurses as established by the MA Board of Nursing; 6.5 hours for social workers as established by the National Association of Social Workers.
	Nursing, License #
	Social Work, License # $35 Processing fee

STEP 5: Payment
	Payment Method:
	My check is enclosed, Payable to RESOLVE of the Bay State
	Or charge to my:
	Visa
	MasterCard
	American Express
	Discover Card
Card #
Exp.Date:
Signature:	__________________________________

STEP 6: Workshop Selection
Select only ONE workshop per person for each session. Hint: Make the most of your registration fee. Attend with a partner or friend and register for eight different sessions total!
	Session A	Session B	Session C	Session D
Person 1
Person 2

STEP 7: Mail or fax this form with your payment to be received at our office by November 5, 2009 at 5 PM.
TO:	RESOLVE of the Bay State, Inc 395 Totten Pond Road, Suite 403 Waltham, MA 02451
OR:	Fax this form with credit card information to 781-890-2249
How did you hear about the conference? Please select the top one or two sources that apply from the following lists:


*Registration fees can be refunded with a written cancellation request received by October 30, 2009. No refunds will be given after that date. Financial Assistance is available. Call 781-890-2225 and leave a message or email our office for details.
** Lunch is not guaranteed with walk-in registration

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with the word "Subscribe" in the subject line OR type your email address
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395 Totten Pond Rd, Suite 403
Waltham, MA 02451

HelpLine: 781-890-2225
Fax: 781-890-2249
email: admin@resolveofthebaystate.org
website: www.resolveofthebaystate.org

Important Note: The information contained in this site is not intended to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Nothing contained in this site is intended to be a substitute for medical diagnosis or treatment.