2014 Congress on Healthcare Leadership - (Page 62)
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REGISTRATION INFORMATION
Congress Express Registration Form
Wednesday and Thursday Only
PRINT YOUR NAME: LAST
FIRST
SECTION 1: Select Basic Registration Fee Events
A. Select events included in your basic registration fee.
Select two Hot Topic Sessions. Each session is worth 1.5 credits
(3 credit hours total).
❍ Wednesday Hot Topic Session #1 ❍ Wednesday Hot Topic Session #2
❍ Thursday Hot Topic Session #1
❍ Thursday Hot Topic Session #2
Indicate if you would like to attend the Wednesday Luncheon.
❍ Leon I. Gintzig Luncheon (Wed.)
Indicate if you would like to attend the Wednesday reception.
❍ Wednesday Congress Reception
B. List below any combination of 1.5-hour and 3-hour seminars that totals 9 CREDIT
HOURS (choose among seminars 72X-118X on pages 34-44).
This includes all numbered seminars and Fellows' Forum #3 (Fellows only).
Please watch for time conflicts, keeping in mind any Career Resource Center programs
and other events you plan to attend.
Seminar
Day
Time
Credits (1.5 or 3)
#
#
#
#
#
#
Total credits: 9
C. List four alternate seminars, in order of preference, in case your first choices are full.
We will have already attempted to get you in both the A and B seminars of your
first choices, so please request different seminars.
Seminar
Day
Time
Credits (1.5 or 3)
#
#
#
#
D. COMPLIMENTARY EVENTS!
Select any of the following:
❍ Special Interest Area Networking Breakfasts, Wed., 7:15 a.m.-8:30 a.m.
Note: You cannot register for both a Special Interest Area breakfast and a
Wednesday Hot Topic Session. Select one:
❍ CEOs
❍ COOs
❍ Early careerists
❍ Group practice executives
❍ Healthcare consultants
❍ Managed care executives
❍ Nurse executives
❍ Physician executives
❍ Post-acute/chronic care
❍ Rural healthcare executives
executives
Congress Express Registration Form
Register online!
Go to ache.org/Congress for more details.
MIDDLE
ID NUMBER
D. COMPLIMENTARY EVENTS! continued
T
❍ homas C. Dolan Diversity Address and Breakfast, Wed., 7:15 a.m.-8:30 a.m.
❍ Advancement Information Session, Wed., 8:45 a.m.-9:45 a.m.
❍ Richard J. Stull Student Essay Presentations, Wed., 8:45 a.m.-10:15 a.m.
J
❍ ob Interviewing Skills Session for students and early careerists,
Wed., 10:45 a.m.-12:15 p.m.
❍ Job Interviewing Skills Session for senior healthcare executives,
Wed., 2:15 p.m.-3:45 p.m.
E
❍ mployment Opportunities in the Federal Sector, Wed., 2:15 p.m.-5:30 p.m.
SECTION 2: Please skip this section.
The Congress Express schedule does not allow for the registration of additional
sessions in this section.
SECTION 3: Purchase Career Programs
Please check for time conflicts before registering for these
Member
Emotional Intelligence Assessment
$160
The Benchmarks Workshop
$650
Benchmarks Plus Emotional Intelligence $750
Change Management Leadership
Assessment Online
$115
Power/Influence Assessment
$115
Leadership Assessment Online
$170
Executive Job Search Workshop
$215
Conflict Management Assessment
$115
Total fee for career programs
$
programs.
Nonmember
$185
❍ Mon.
$745
❍ Mon.
$845
❍ Mon.
$130
$130
$220
$255
$130
❍ Tues.
❍ Tues.
❍ Wed.
❍ Wed.
❍ Wed.
SECTION 4: Purchase Pre-Congress Activities
Select from the following pre-Congress activities:
I
❍ mproving the Patient Experience to Build Customer Loyalty ($1,375 members/
$1,575 nonmembers)
I
❍ mproving Hospital-Physician Relations: A Journey From Autonomy to
Partnership ($1,375 members/$1,575 nonmembers)
❍ Baldrige Boot Camp ($880 members/$1,030 nonmembers)
❍ CEO Boot Camp ($880 members/$1,030 nonmembers)
❍ COO Boot Camp ($880 members/$1,030 nonmembers)
❍ Middle Manager Boot Camp ($710 members/$850 nonmembers)
❍ New Healthcare Leader Boot Camp ($710 members/$850 nonmembers)
❍ Physician Executive Boot Camp ($880 members/$1,030 nonmembers)
Total fee for pre-Congress activities
$
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62
http://www.ache.org/congress/congapps/registration/
Table of Contents for the Digital Edition of 2014 Congress on Healthcare Leadership
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2014 Congress on Healthcare Leadership
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