NLMA Forms
Medical Assistance in Dying (MAiD) Workshop Registration Form

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Instructions Use this form to register for the Medical Assistance in Dying (MAiD) workshop.

Registrant (NLMA Members ONLY)

Name

NLMA Number

Badge Name

Badge Title

Diet/Allergies

Registrant (Non-NLMA Members ONLY)

Name

Organization

Job Title

E-mail

Badge Name

Badge Title

Diet/Allergies

Registration

Registration*

Date
Registration closed January 27 (Grand Falls-Windsor)
Registration closed February 10 (St. John's)
March 10 (Corner Brook)
April 28 (Happy Valley-Goose Bay) - DATE CHANGE

Notes

Requests/Questions


(*required)

Policies
Deadline
Registration closes 5 pm, Wednesday, January 24; Wednesday, February 7; Wednesday, March 7; and, Wednesday, April 25, respectively.
Cancellation Cancellations received by January 24, February 7, March 7, and May 1 will receive a full refund less a $25 cancellation fee. There will be no refunds for cancellations received after the close of registration due to catering commitments. You may send another colleague in your place.


Assistance For assistance, please contact Anna Delaney, Communications Coordinator at (709) 726-7424 (314), (800) 563-2003 (314) or adelaney@nlma.nl.ca.

Newfoundland and Labrador Medical Association
164A MacDonald Dr., St. John's, NL, Canada, A1A 4B3
Telephone (709) 726-7424 | Toll Free (800) 563-2003 | Fax (709) 726-7525
E-mail nlma@nlma.nl.ca | Web www.nlma.nl.ca