Get Advanced Practice Providers Conference - University Of Mississippi ... - Umc

This guide provides a step-by-step approach to filling out the Advanced Practice Providers Conference registration form online. Whether you're a novice or experienced user, this comprehensive guide aims to simplify the process for a successful completion.

Follow the steps to complete the registration form effectively.

1. Click ‘Get Form’ button to obtain the registration form and open it in your online document editor.
2. Enter your basic information. Fill in your full name, including your last, first, and middle initial as required.
3. Provide the last four digits of your social security number, which is necessary for continuing education credit.
4. Input your home address, including street address, apartment number (if applicable), city, state, and zip code.
5. Complete your daytime telephone numbers and a valid email address for registration confirmation.
6. Select the appropriate box that matches your area of practice such as 'Advanced Practice Provider', 'Nurse Practitioner', 'Certified Nurse Midwife', 'Nurse Anesthetist', or 'Physician Assistant'. If your role does not fit these categories, provide a specification in the designated area.
7. Review the registration fees and select the appropriate payment option based on your status as a UMMC employee or non-employee. Consider additional fees for specialized workshops, if applicable.
8. Provide payment information: either include a check or money order, or enter your credit card details, ensuring you fill in the card number, security code, and expiration date.
9. If you are a UMMC employee, complete the payroll deduction section, including your employee number and signature.
10. Review the form for accuracy and completeness before submitting. Then, you can mail the completed form to the provided address or fax the credit card payment to the designated number.
11. If needed, indicate if you require special accommodations by checking the appropriate box on the form.
12. Once completed, save changes, and consider downloading, printing, or sharing the completed form as appropriate.

Complete your registration for the Advanced Practice Providers Conference online today!