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32nd Annual Health Care
Roundtable Seminar
  Wednesday, October 06, 2010
Hyatt Regency Wichita
400 W. Waterman
Wichita, Kansas
 Pre-Registration To better help us in planning the roundtable,  please use the form below to let us know
how many in your company will be attending. Upon Submission You will have the option
to print out this form to send along with your payment.

NumberAttending:
  		Address:    
Name:       
   		 Street:     
Work Tel:   
  		Apt/Suite:
City:       
 		 State:       
E-mail:        
  		Zip Code:
Please use the extra boxes below to give us information on your people that will be attending.

Name1:        E-mail1:       
Name2:        E-mail2:       
 Name3:       E-mail3:       
Name4:        E-mail4:       
Name5:        E-mail5:       
Name6:        E-mail6:  
Name7:        E-mail7:  
Name8:        E-mail8:  
Name9:        E-mail9:  
Name10:      E-mail10:


 
 
 
 
 
 
Registration Deadline: September 30, 2010
If you have any questions or concerns, please call Denise at 316-683-7557.
Refund Policy: If someone needs to cancel their reservations, we would ask them to find a replacement. If that is not possible, we will refund the fees to them up to five (5) days before the event.

Privacy Policy: The Sedgwick County Health Care Roundtable does not sell or distribute our members information to outside entities.