This Chair Rocks – A Manifesto Against Ageism – Registration Name:* First Last Company:* Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone:* Primary Contact Email:* List your Degrees, Licenses, and/or Certifications:* (enter N/A if not applicable)How many year of experience do you have in care management?* (enter N/A if not applicable)I would like a CMC CE Certificate:* Yes No How did you hear about us?Select OneNACCM NewsletterSocial MediaALCA/Other newsletterColleagueAuthorOtherHow did you hear about us? Other Registration Options:*Select OneNon-CMCCMC (enter coupon for $20 credit)CMC Coupon Code:* ($20 discount)TOTAL: $0.00 Once you press "Pay Now", you will be redirected to Paypal.com. You must complete your payment before your registration is received and processed.You will receive email notifications with event details and instructions prior to the event. Δ
