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2016 IU School of Nursing Alumni Weekend Registration Form

FRIDAY, April 29th, 2016
8:00 a.m. – 4:30 p.m. / ·  Distinguished Lectureship-“Cultivating Healthy Populations: Inspiring a Collective Vision” at the NCAA Conference Center, 700 W. Washington St., Indianapolis, IN, 46204, Christine Grant Ballroom. Featured speakers include:
·  Dr. Debra Barksdale, Associate Dean for Academic Programs, Virginia Commonwealth University
·  Dr. Marion Broome, Dean, Duke University School of Nursing
·  Dr. Virginia Caine, MD, Director, Marion County Department of Health
·  Dr. Karen Drenkard, Chief Clinical and Nursing Officer, GetWellNetwork
·  Dr. Linda Q. Everett, previous Chief Nursing Executive, IU Health
·  Dr. Victoria Niederhauser, Dean, University of Tennessee-Knoxville, School of Nursing
For more information and to register, go to this website: http://tinyurl.com/je8paxy
5:15 p.m. – 6:30 p.m. / All-alumni welcome reception and presentation of annual IU School of Nursing Alumni Award (Indiana State Museum, 650 W. Washington St., Indianapolis, IN, 46204 - Canal Overlook Bridge)
6:30 p.m. / Class of 1966 50th Reunion Dinner (Indiana State Museum – L.S. Ayers Tea Room)
SATURDAY, April 30th, 2016
11:00 a.m. – 1:00 p.m. / Brunch for class of 1946, 1951, 1956, 1961, 1966, 1971 with remarks from Alumni Association president Eric Newsom
(Ball Residence Hall and Gardens, 1226 W. Michigan St., Indianapolis, IN 46202)
1:15 p.m. - 2:30 p.m. / Bus Tour of IUPUI Campus, tours of IU School of Nursing and Simulation Labs, and Eskenazi Hospital
2:30 p.m. – 4:00 p.m. / Afternoon Tea with the Dean of IU School of Nursing
·  School of Nursing update from Dean Robin Newhouse
·  Presentation on the Ball Gardens restoration project
(Ball Residence Hall and Gardens, 1226 W. Michigan St., Indianapolis, IN 46202)
6:00 p.m. / Class of 1961 Dinner hosted at the home of Kay Enderle


Payment: Please return this page by April 21st

Schedule of Events
Event Name / Number in party
and name of guest(s)
Fill in this row / Cost Per Person / Total $
Fill in this row
Friday, April 29
All Alumni Welcome Reception / Complimentary for registrant; $15/ per guest
Class of 1966 Dinner / $30/per person
Saturday, April 30
Brunch / $20/per person
Tours:
·  IUPUI campus tour,
·  IU School of Nursing, Simulation labs,
·  Eskenazi Hospital / Complimentary
Afternoon Tea with
Dean Newhouse / Complimentary
Class of 1961 Dinner hosted at the home of Kay Enderle / Complimentary
Total Amount Due: $
Please Select One for Primary Registrant: / Alumnus/Alumna ☐ / Non-Alumni ☐

Full Name ______

Address Line 1 ______

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City ______State ______Zip ______

Home Phone ______Cell Phone ______E-Mail ______

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For Name Tag Purposes

Primary Registrant First Name ______Last Name ______

Maiden Name ______ / Graduation Year & Degree ______
If not an alumnus/alumna, write “N/A”

MARK ONE OF THE FOLLOWING:
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