2019 Annual Conference Registration

Registration Options (Regular Registration Ends Feb. 21)

Quantity
Price
Total
Regular Pricing - Full Conference (Member)
X
$
325.00=
$
0

Regular Pricing- Full Conference (Non-Member)
X
$
375.00=
$
0

Regular Pricing - 1 Day Thursday Conference (Member)
X
$
200.00=
$
0

Regular Pricing - 1 Day Friday Conference (Member)
X
$
200.00=
$
0

Final Total:
$
0

Ancillary Events

Are you attending the Spring Quarterly Meeting on Wednesday, March 6 from 1:00-3:00 pm?
  • Yes
  • No

Contact Information

Job Title
Organization
Credentials (Please indicate all that apply)*
  • IBCLC
  • CLC
  • BPC (Breastfeeding Peer Counselor)
  • Community Health Worker
  • Nutritionist
  • Midwife
  • RN
  • CNP/NP
  • PA
  • MD/DO
  • Other
  • N/A
Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Membership

To become a member sign up at  New Mexico Breast FeedingTask Force Membership Page.  As a member of the New Mexico Breastfeeding Task Force, you will be making an important contribution to improving the health status and reducing health care costs of New Mexico families through the advancement of breastfeeding.

 

Membership Benefits

  • Discounted tuition at Task Force sponsored events, including our Annual Conference and Hospitals/Clinics Summit
  • Statewide networking
  • Quarterly meetings: travel reimbursements (based on need and distance) and free child care for children (1yr and older)
  • Access to resources for lactation professions
  • Technical assistance and tool kits
  • Member-only funding/project support
  • Statewide promotion of your local breastfeeding efforts and events
  • Opportunities to contribute through committee activities
  • Regular updates regarding evidenced-based breastfeeding practices, advocacy efforts, resources, and upcoming events
  • Scholarship opportunities for IBCLC exam and renewal fees
  • Chapter leadership opportunities and professional development
  • A voice and vote in determining the future direction and focus of the New Mexico Breastfeeding Task Force
Are you a current member of the NM Breastfeeding Task Force?
  • Yes
  • No

Additional Information

Have you attended the New Mexico Breastfeeding Task Force annual conference before?
  • Yes
  • No
Do you have any dietary restrictions?
  • Vegetarian
  • Vegan
  • Gluten-Intolerant
  • Lactose Intolerant
  • Combination or Other
Special Accomodations
  • Mobility
  • Communication (Interpretation)
  • Combination or Other
For data purposes, please indicate which ethnicity you identify as.*
  • White/Caucasian
  • African American
  • Hispanic
  • Native American
  • Asian American
  • More than one race/ethnicity

Childcare

For more information on childcare please contact monica@breastfeedingnm.org . Childcare must be paid in full by February 28th to secure your space.

If you need childcare, please indicate the days needed below.
  • Wednesday (Quarterly Meeting)
  • Thursday: $25.00
  • Friday: $25.00
What are the names of ages of children needing care?

Payment Information

Amount*
$
Name on Card*
Card Number*

Security Code

Share This Form

Powered by eTapestry.