CIC Prep Course - 2023 - Alabama Hospital Association

Register for Course

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AlaHA, in conjunction with the Alabama Regional Center for Infection Prevention, is offering a prep course for those planning to take the Certification in Infection Control (CIC) exam this year. The $75 registration includes an APIC CIC Study Guide, one in-person meeting, 8 virtual sessions, and access to online APIC Text.

Hospital:*

Name*

First Last

Occupation/Title*

Address (This is where your CIC Study Guidebook will be mailed. We cannot mail to P.O. boxes.)*

Phone:*

Email:*

2. Attendee Registration

Hospital:

Name

First Last

Occupation/Title

Address (This is where your CIC Study Guidebook will be mailed. We cannot mail to P.O. boxes.)

Phone:

3. Attendee Registration

Hospital:

Name

First Last

Occupation/Title

Address (This is where your CIC Study Guidebook will be mailed. We cannot mail to P.O. boxes.)

Phone:

4. Attendee Registration

Hospital:

Name

First Last

Occupation/Title

Address (This is where your CIC Study Guidebook will be mailed. We cannot mail to P.O. boxes.)

Phone:

5. Attendee Registration

Hospital:

Name ($75/registrant)

First Last

Occupation/Title

Address (This is where your CIC Study Guidebook will be mailed. We cannot mail to P.O. boxes.)

Phone:

Email:

Make Your Payment:

The cost for the course is $75 per registrant.

Payment Method:*

Pay by Check

Pay by Credit Card

Total payment amount. ($75 times the number of registrants)*

Paying by check:

Click the “Submit Form” button below to send your registration to AlaHA. Make your check payable to the Alabama Hospital Association and mail payment, along with a copy of the registration to: Alabama Hospital Association, 500 North East Blvd., Montgomery, Ala. 36117. Once you click “Submit Form,” a copy of the form can be printed for your records and to accompany the payment.

If you have multiple registrants from your hospital,

Name

This field is for validation purposes and should be left unchanged.

CIC Prep Course – 2023

Register for Course

2. Attendee Registration

3. Attendee Registration

4. Attendee Registration

5. Attendee Registration

Make Your Payment: