DATE: Tuesday, September 18, 2018
TIME: 8:00 a.m. to 4:30 p.m.
(Continental Breakfast and light lunch provided.)
LOCATION: Eastern Iowa Community College
West Davenport Center Room A
2950 N Fairmount
Davenport, IA 52804

This program is intended for Direct Care staff in any health, long term care or community setting serving Iowans of all ages and abilities. If you have any questions, please contact the Iowa CareGivers at 515.223.2805. Thanks

Notice: A separate registration is required for each person attending.

*First Name:
*Last Name:
  Mr.   Mrs.  Ms.
*Complete Home mailing address:
*Home phone:
Work phone:
Cell phone:
Employer Address:
Employer City:
Employer State:
Employer Zip:
Do you have any special dietary needs? Yes    No
Please list here:
      Please Select Your Occupation (check all that apply):
Certified Nursing Assistant (CNA) Consumer Directed Attendant Care
(CDAC) worker
CNA plus other certification, such as medication aide, rehabilitation aide, etc. Direct Support Professional
Home Care Aide (HCA) Hospice Aide
Home Health Aide (HHA) Companion, non-medical assistant
Universal Worker Family Caregiver
Patient Care Technician (PCT) Other
What is the capital city of Iowa?