2018 New Mexico Hospitals & Clinics Maternity & Infant Care Summit Registration: Bridging the Gap

November 8, 2018 8:00 am - 5:00 pm

at Wyndham Hotel and Conference Center

Contact Information

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*

Additional Information

Company Name
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
How Did You Hear About the 2018 Summit?*
Are you currently a NMBTF member?*
  • Yes
  • No
Are you requesting any accommodations (for example, a disability need, or a language interpreter) for this Summit?
Do you have any dietary requests? (Every effort will be made to accommodate your needs.)
For data purposes, please indicate which ethnicity you identify as.*
  • White/Caucasian
  • African American
  • Hispanic
  • Native American
  • Asian American
  • More than one race/ethnicity

Registration Options

Summit Agenda

PLEASE CHOOSE FROM THE FOLLOWING OPTIONS.  

IF YOU HAVE QUESTIONS OR NEED ASSISTANCE, EMAIL US AT contact@breastfeedingnm.org

  • REGULAR REGISTRATION: If you are not presenting a poster, are not a NMBTF member, or do not have team code, please choose this option.
  • REGISTRATION WITH A POSTER PRESENTATION:  If you have signed up to present a poster at the Poster Session, please choose this option.
  • REGISTRATION AS A NEW MEXICO BREASTFEEDING TASK FORCE (NMBTF) MEMBER: Email contact@breastfeedingnm.org if you need assistance in checking your NMBTF member status or to get your member number.  You can also join the NMBTF here.  Please enter your member number below when selecting this option.
  • REGISTRATION OF 4 OR MORE REGISTRANTS: Email monica@breastfeedingnm.org to get your team code.  Please enter that code below when selecting this option.

 

PLEASE REGISTER ONLY ONE PERSON PER FORM.

To ensure each registrant's information is recorded, register each person separately.  

Contact Monica, at monica@breastfeedingnm.org, for further assistance.

Quantity
Price
Total
Regular Registration
X
$
149.00=
$
0

Registration with a Poster Presentation
X
$
75.00=
$
0

Registration as a NMBTF Member

Enter your member number below after selecting this option

X
$
126.00=
$
0

Registration of 4 or More Registrants

Enter your team code below after selecting this option

X
$
126.00=
$
0

Final Total:
$
0
NMBTF Member number
Team Code for 4 or more Registrants

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

Security Code

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