Include a $10 late fee with registrations submitted after February 23rd

Registrant

Name:
Title or Degree:
Address:
City:State:Zipcode
Email Address:
Phone #:

Employer/Organization/School:

Check all that apply:

RN
IBCLC
BSN
RNC
LPN
RD
MD
La Leche League Leader
Other (specify):

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If you have special needs to fully participate in this conference, please share them with the registrar.
Please indicate your need:

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Please enter the amount you owe in the "Total" column (No $ sign, just the number.) Once you select the Confirm / Pay button, your total will be displayed and you will then have the opportunity to confirm and pay or cancel and return.

Basic Registration	Cost:	Total:
Health Care Professional	$120
Health Care Professional and LLLI Member	$100
Student (include verification from school of student status)	$95
La Leche League Leader/Leader Applicant	$70
LLLI Membership (includes New Beginnings subscription)	$40
Late fee after February 23rd	$10

If you have questions about registration or these registration materials, contact Jolene Mosley at jolene-de-dc.org or (410) 905- 5208.

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