SAFE HANDLING AND PREPARATION OF HAZARDOUS DRUGS
COURSE REGISTRATION

To register for this course, please complete the form below. For any additional questions regarding this course, the registration process or the STAR Center itself, please call 303.617.2229 or 800.567.BAXA (2292) extension 2229.

* Denotes a required field or option.

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Prefix Ms. Mrs. Mr. Dr.

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State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY   *     Province AB BC MB NB NL NS NU ON PE QC SK YT   *       *

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State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY   *     Province AB BC MB NB NL NS NU ON PE QC SK YT   *       *

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Preferred Mailing Address:  *

 - Home      - Business

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Special Lunch Requirement:

 - Vegetarian

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Preferred Date(s):  *
In order to maintain optimal class size for hands-on practice and cleanroom access, registration is limited to the first 20 respondents for each session. Please indicate preferred session below:

Please Select a Date Below: ------------------------------------------- January 27, 2009 February 10, 2009 May 19, 2009 July 21, 2009 August 18, 2009 October 13, 2009

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How Did You Hear About STAR Center?  *

 - Direct Mail      - Email

 - Tradeshow      - Sales Representative

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Notifications:

  - Yes! I would like to be contacted about future promotions and Baxa products.

  - Yes! I am interested in participating in future market research projects.

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Payment
Registration for the 2 - 1/2 day course is $1175.00. Discounts may be offered to multiple attendees from a single facility. Contact the STAR Center or your Baxa Corporation representative for details. Once Baxa has received your registration, a Baxa Associate will contact you to process your payment.

Travel Arrangements
Participants must make all airline, shuttle and hotel reservations. Upon registration, an information packet will be mailed that details hotel recommendations and corporate rates. For more information on travel arrangements, contact the STAR Center Coordinator at 303.617.2103.

Cancellation Policy
Registration cancellations must be made in writing to the STAR Center no later than two weeks before the session. Refund requests are subject to a $50.00 cancellation fee. Registration may be deferred to a later scheduled session.

Questions?
Please contact the STAR Center Coordinator at 303.617.2229 or 800.567.BAXA extension 2229.

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Additional Comments