Centre for Innovation in Complex Care (CICC)

GIM Amazing: Leading Practices in the 21st Century (GIM2009)

October 14, 2009

Online Registration

This year, the University Health Network (UHN) is sponsoring this event for attendees who work at any one of the three sites. For interested attendees outside of UHN there is a charge of $75.00 to cover the cost of lunch and beverages. Space is limited to the first 200 guests to register.

The deadline for registration is October 9, 2008. Confirmation of registration and receipt of payment will be by return email.

As lunch is provided we require notification of 3 days for any cancellations.

For assistance, please contact Anne Van Deursen at anne.vandeursen@uhn.on.ca.

* = mandatory field

	Title (Occupation)*

	First*
	Last*
	Are you UHN Staff? Yes No
	If YES please provide the following:
	UHN Site
	UHN ID (last nine digits on back of UHN Photo ID)
	If NO please provide the following:
	Hospital/Organization
	For interested attendees outside of UHN there is a charge of $75.00 to cover the cost of lunch and beverages. Please note, your registration will not be considered complete until we have received your registration payment.
	Email Address*

	Telephone*

Please ensure that you have completed all fields before clicking the submit button