Invite You to Attend The

1

Invite you to attend the

2014 Festive Season Dinner

Location: / Best Western Plus Stoneridge Inn & Conference Centre
6675 Burtwistle Lane, London, ON N6L 1H5
Date: / Thursday, January 23, 2013
Guest Speakers: / Karen Perkin | Vice President, Acute and Ambulatory, Professional Practice, and Chief Nurse Executive of St. Joseph’s Health Care London
Amanda Thibeault| Director of Nursing Practice, St. Joseph’s Health Care London
Topic: / “Learning in Mentorship while Leading in Change”
Agenda: / 5:00 pm – Registration Opens
5:30 – 6:00 pm – STTI Iota Omicron Chapter Business Meeting
6:00 – 6:30 pm – RNAO Middlesex-Elgin Chapter Business Meeting
6:30 pm – Registration Continues & Cash Bar Opens
6:50 pm – Welcoming Address
7:00 pm – Dinner
8:00 pm – Guest Speakers
Cost: / STTI/RNAO Members - $40.00/person
Non-Members - $45.00/person
Students - $25.00
(Note: There is no charge to attend the business meetings only.)

All are welcome to attend the business meetings. If you plan to attend the dinner after the business meetings, please print, fill-out, and mail the second page of this form with your cheque payableto Iota Omicron Chapter by January 13, 2014.Please mail to Angela Law at this address: Health Sciences Addition, Room H3 Arthur Labatt Family School of Nursing, Western University, London, ON, N6A 5C1

2013-2014 STTI/RNAO FESTIVE DINNER REGISTRATION FORM

This registration form can register up to three (3) attendees, if more is needed, please print another form.

Registrant’s Name: ______

Contact email: ______

Attendee 1 Name (to appear on table card):
______ / Circle one that applies to your payment:
STTI or RNAO Member - $40.00
Non-Member/Guest - $45.00
Student - $25.00
Entree (choose one):
Asparagus Stuffed Breast of Chicken with Chardonnay Wine Sauce
OR
Grilled Salmon with Apricot Glaze / Please indicate any allergies or other preferences: ______
Attendee 2 Name (to appear on table card):
______ / Circle one that applies to your payment:
STTI or RNAO Member - $40.00
Non-Member/Guest - $45.00
Student - $25.00
Entree (choose one):
Asparagus Stuffed Breast of Chicken with Chardonnay Wine Sauce
OR
Grilled Salmon with Apricot Glaze / Please indicate any allergies or other preferences: ______
Attendee 3 Name (to appear on table card):
______ / Circle one that applies to your payment:
STTI or RNAO Member
Non-Member
Student
Guest
Entree (choose one):
Asparagus Stuffed Breast of Chicken with Chardonnay Wine Sauce
OR
Grilled Salmon with Apricot Glaze / Please indicate any allergies or other preferences: ______

Please consider a donation to support student involvement in this joint festive dinner event.

I would like to donate ______(e.g., $5, $10, $20 other $ amount).

Enclosed is my cheque made payable to Iota Omicron Chapter for the total amount of $______

Please submit this page with cheque by January 13, 2014 to Angela Law, Health Sciences Addition, Room H3 Arthur Labatt Family School of Nursing, Western University, London, ON, N6A 5C1

DIRECTIONS AND MAP TO VENUE

From: All directions. Use GPS coordinates:

Latitude 42.850406:
Longitude -81.274456

Important: Map and directions are for information purposes only. While we hope to provide the best mapping information for Best Western hotels, some mapping details may not be as accurate as we would like. Please contact hotel directly to obtain the most current and complete location information and driving directions. Hotel phone number: 519/652-6022

STTI Iota Omicron & RNAO Middlesex 2014 Festive Dinner