Conference Flyer with registration

Page 1

April 2, 2015

Nessmith-Lane Conference Center Statesboro, GA

UNDERSTANDING DEMENTIA AND ALZHEIMER’S Conference Hosted by Georgia Southern University Division of Continuing Education, Willow Pond and Willow Pond at Home

ABOUT THE CONFERENCE

Agenda, April 2, 2015 8 – 8:30 a.m. 8:30 – 8:45 a.m. 8:45 – 10:15 a.m.

10:30 a.m. – 12:15 p.m.

12:30 – 1:45 p.m.

1:45 – 2:45 p.m.

2:45 – 3 p.m. 3 – 4 p.m. 4 – 4:15 p.m.

Registration/ Continental Breakfast Welcome Dementia 360 Teepa Snow, MS, OTR/L, FAOTA, Dementia Care & Training Specialist, Positive Approach, LLC, Efland, NC How to Communicate with Someone Who has Dementia Teepa Snow, MS, OTR/L, FAOTA, Dementia Care & Training Specialist, Positive Approach, LLC, Efland, NC Lunch/Exhibitor’s, Door Prize Announcements Special Presentation – Theresa Winters Bayman, Alzheimer’s Association, Georgia Chapter/Coastal Region, Savannah, GA Could This Be Alzheimer’s? Dr. Christina M Negrea, MD, Memorial Health University Medical Center, Savannah, GA Break/Exhibitors Long Term Care Preparation Jeffery Williamson, J. L. Williamson Law Group, LLC, Statesboro, GA

This one day conference will provide the attendees with cutting edge information about dementia, Alzheimer’s disease and forgetfulness. This conference will provide healthcare professionals and caregivers with positive approaches for working with persons with dementia. Also, discriminate among the terms: dementia, Alzheimer’s disease, and forgetfulness; Describe symptoms that commonly occur with Alzheimer’s disease/dementia based or brain damage; recognize behaviors that are indicative of dementia-related conditions.

CONFERENCE FEES

Your conference fees includes a light continental breakfast, lunch, sessions and credits.

$99 Regular Registration $125 Late Registration after 3/20/2015

Closing Remarks

SPONSORSHIPS LEVELS SILVER SPONSORSHIPS $500

BRONZE SPONSORSHIPS $250

VENDOR SPONSORSHIPS $75, plus $25 door prize (lunch not included)

Our Silver Sponsors will receive: (2) Tables, (2) Chairs, (2) Lunches, (2) Breakfast, Silver sponsor recognition on all materials/website, Additional Lunch tickets available to purchase $15 Our Bronze Sponsors will receive: (1) Tables, (1) Chairs, (1) Lunches, (1) Breakfast, Bronze sponsor recognition on all materials/website, Additional Lunch tickets available to purchase $15 Our Vendor Sponsors will receive: (1) Table, (1) Chair, (1) Breakfast, Lunch tickets available to purchase $15

http://academics.georgiasouthern.edu/ce/conferences/dementia/

CON TIN U IN G E D U C AT I O N

Questions? Contact Us MARY JERNIGAN

912.478.2584 dementiaalzeimers@georgiasouthern.edu


DIVISION OF CONTINUING EDUCATION Georgia Southern University

REGISTRATION REQUEST

Mail, fax, email or phone form to:

PROGRAM # 15DACCE2369A Understanding Dementia and Alzheimer’s Conference April 2, 2015 Nessmith-Lane Conference Center, Statesboro, GA

Continuing Education Registrations P.O. Box 8124 Statesboro, GA 30460-8124 Phone: 855-478-5551 (toll-free) Fax: 912-478-0847 email: CE-Registrations@georgiasouthern.edu

1. Registrant Information Name: Last First MI Employer/Organization: Title: Address o Home

o Work:

City: State: ZIP: Cell Phone #: Home Phone #: FAX #: email (Required for e-mail receipt):

2. Amount Due * Fee includes a light continental breakfast, lunch, sessions and credits.

o $99 Full Conference Fee $125, Late Registration after 3/20/2015 $

Total $

3. Method of Payment

o Personal check (Payable to Georgia Southern University) (include attendee’s name, course number, and course date on all checks.) o Organization check (Payable to Georgia Southern University) o Credit Card o personal o VISA

o corporate

o MASTERCARD

o AMEX

o DISCOVER

Account Number: Expiration Date: Security code: Cardholder’s Name: (please print) Signature:

SPECIAL ACCOMMODATIONS: For special assistance, please request accommodation needs at least 14 working days in advance of the program. CANCELLATION POLICY: Refund requests must be received by 3/27/2015 to ensure refund. A $25 administrative fee will be deducted. Substitutions are suggested instead of cancellations. No refunds are given to registrants who fail to withdraw prior to the program.


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