Please fill out the form below and click the submit button at the bottom of the form ONE time only! If you feel you have had any problem or questions with the registration portion, feel free to e-mail us at  regina.pearson@tnemsea.com

Last Name	*
First name	*
Title	*
Teaching Since (year)
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City	*
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E-mail Address	*
Phone Number	*
EARLY BIRD FEES BEFORE JULY 5, 2011. SELECT ONLY 1 OPTION FOR EITHER 2 DAY OR 1 DAY CONFERENCE.
CONFERENCE REGISTRATION OPTIONS	* IF YOU ARE SELECTING A 1 DAY CONFERENCE YOU CAN ONLY CHOOSE ONE OF THE TWO DAYS. IF YOU PLAN TO ATTEND BOTH DAYS THEN YOU MUST SELECT A TWO DAY CONFERENCE OPTION!	2-DAY CONFERENCE REGISTRATION (INCLUDES BANQUET TICKET AND WING BASH TICKET) 2-DAY CONFERENCE REGISTRATION + TEMSEA MEMBERSHIP (INCLUDES BANQUET AND WING BASH TICKETS) 1-DAY CONFERENCE REGISTRATION THURSDAY ONLY 1-DAY CONFERENCE REGISTRATION FRIDAY ONLY (INCLUDES WING BASH TICKET) STUDENT CONFERENCE ATTENDANCE ONLY NAEMSE II POST CONFERENCE COURSE (NAEMSE & TEMSEA MEMBERS) NAEMSE II POST CONFERENCE COURSE (NON-NAEMSE & TEMSEA MEMBER) EXTRA BANQUET TICKET ($30 FOR GUEST) NON-TEMSEA MEMBER BANQUET TICKET ($30) REGULAR MEMBERSHIP DUES (ONLY IF YOU DIDN'T SELECT 2-DAY CONFERENCE WITH DUES) ASSOCIATE MEMBERSHIP DUES (ONLY IF YOU DIDN'T SELECT WITH 2-DAY CONFERENCE)
NUMBER OF EXTRA WING BASH TICKETS NEEDED: ($20 EACH)		----Select One---- 1 2 3 4 5 6
THURSDAY SESSION CHOICES (CHOOSE ONE FOR EACH TIME SLOT)		09:45 – Crew Resource Management: A Down to Earth Idea- Rice 09:45 – Clinical Applications of Waveform Capnography- Belle 09:45 – 2010 AHA Guideline Update- Lankford 11:00 – Pulmonary Edema or Pneumonia: The Classic EMS Diagnosis- Kanarian 11:00 – They’re little, not little people, but they have big issues: Pediatric Care- Helton 11:00 - Vital Signs: Back to Basics - Le Baudour 14:45 – Do You Remember Why You Signed Up?- Ludwig 14:45 – New Tools and Technologies in EMS Education- Slaven 14:45 – A Blended Approach to Recertification- Belle 16:00 – Smile: Customer Service for EMS- Miller 16:00 – Mask CPAP: Applications and Protocols: The Who, What and How for Emergency Medicine- Fry 16:00 – The Many Faces of Abuse & Neglect - Le Baudour
FRIDAY SESSION CHOICES (CHOOSE ONE FOR EACH TIME SLOT)		PROCEDURAL ANATOMY LAB 14:30 09:15 – Ignorance Indifference- Page 09:15 – Polishing Your Leadership Skills…Learn to Fish- Lindsey 09:15 – 2010 AHA Guideline Update- Lankford 10:30 – Stroke: Ischemic v. Hemorrhagic- Arthur 10:30 – Teaching with YouTube Le Baudour 10:30 – Mask CPAP: Applications and Protocols: The Who, What and How for Emergency Medicine- Fry 13:15 – A “Frank” Look at Leadership and Mentoring- Logan 13:15 – Clickers- Page 13:15 – NFPA 1584: How to establish a rehab system- Lindsey 14:30 – Ethics for the EMS Leader - Le Baudour 14:30 – Teacher Say, Student Do - Page 14:30 – Aeromedical Utilization- Clark
NAEMSE POST CONFERENCE CLASS. PLEASE ENTER YOUR TEMSEA OR NAEMSE MEMBERSHIP NUMBER:
TEMSEA BANQUET	*	I PLAN TO ATTEND THE BANQUET I WILL NOT BE ATTENDING THE BANQUET I WILL BE BRINGING A GUEST I WOULD LIKE TO ATTEND BUT I AM NOT A MEMBER I PLAN TO ATTEND THE WING BIRTHDAY BASH
EXTRA PEOPLE ATTENDING BANQUET WITH YOU :
EXTRA PEOPLE ATTENDING WING BASH WITH YOU:
Total due:
*= Required Field