CNE (Virtual) Registration

VIRTUAL REGISTRATION ENDS FRIDAY DECEMBER 6, 2024 at 8:00PM CST

Virtual registration will close at the end of the business day at 8:00PM CST.

No exceptions!

Upon successful completion of your online registration here, you will be redirected to register for the zoom application.

ZOOM LINKS are provided by the zoom software (not ANA Board members) upon your successful completion of this form. Zoom registration MUST be completed to receive links for viewing the conference. The participant is responsible for downloading and / or updating zoom software for their personal computer and smart devices.

Please email ceu@naprapath.org if you do not receive a zoom registration link following your successful check out.

Virtual Event Registration Form

2024 ANA (Virtual/Pre-Pay) Winter Holiday Conference Registration - Prepayment Required

This form is for participants who plan to attend the event virtually. If you are seeking to attend this event in person, please complete the appropriate registration form from the Convention Registration page on the ANA website. Thank you for your cooperation and participation. After successfully checking out, you should be directed to register on zoom so that you may receive the link to join the virtual seminar. Allow 1 business day to receive an invitation from zoom with meeting ID and other details to join the meeting. Please email ceu@naprapath.org if you do not receive a zoom link invitation to "join meeting" or "add meeting to calendar" by Friday, December 6, 2024 after virtual registration closes.

Name *

First

Last

Email *

Phone *

Please provide your IL or NM DN License number

IL licenses 181-000-XXX. License numbers are used to verify active membership. Renew your ANA membership today.

DN License Number *

If you once had a license number and it is inactive, you may write that here. Or you may write 9999 if you are not a licensed DN.

The ANA Winter Holiday Conference is an all day 1-day event

Continuing Education Units are provided for each day upon completion of morning and afternoon seminars. All is welcome to join us this weekend. Online payment for this event is at the end of this form.

We appreciate the great feedback we received from our last event to improve your virtual experience. We are excited to reveal the innovative ways of virtual engagement for this event.

How are you attending this year's holiday conference? *

Member - Sunday, December 8 ($154.50)
Non-Member Sunday, December 8 ($206)

Certificate of Completion Submission is by EMAIL ONLY

Participants will receive their certificates of completion by email only. We will submit to the email placed on this registration. NOTE: There is a an additional fee ($15) to print and mail current as well as a previously issued CEU certificate of completion.

Print my credentials or license number on my Completion Certificate(s) - OPTIONAL

I would like my credentials AND license number printed on certificate - $ 5.00
I would like my credentials printed on certificate - $ 2.50
I would like my license number printed on certificate - $ 2.50

Printed license numbers are limited to 2 (including DN license number).

Credentials (Optional) *

If selected from above. Please provide your name and credentials (including DN degree) as they should be displayed on your certificate. Please limit credentials to up to 2 actual degrees awarded, space is limited. ***May write N/A, if not applicable to you.***

Other License Info (Optional) *

If selected from above. Please provide your license type and number to be displayed. Printed license numbers are limited to 2 (including DN license number). ***May write N/A, if not applicable to you.***

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Please be sure that ANA has current mailing details if your certificate is to be mailed at a later date. This option applies for any credentials or license info added to certificate of completion.

Keep In Touch with the ANA

I would like to receive email updates regarding future conferences

ANA Membership Reminder. ANA fees are due annually June 1st.

ANA fees are due annually June 1st. ANA Membership term is annually June 1st - May 31st. After July 1st, a $20 late fee is applied to your account. Renew your membership to unlock more incentives through the ANA.

Join / Renew Membership with ANA today!

Membership / Renewal Contribution *

I am current with my Annual ANA Membership Contribution - $ 0.00
I would like to pay my membership / renewal (Licensed DN) - $ 220.00
I would like to pay my membership / renewal (Affiliate) - $ 170.00
I would like to pay my membership / renewal (Naprapathic Graduate Intern) - $ 95.00
I would like to pay my membership / renewal (Naprapathic Student Intern) - $ 70.00
I may join /renew my ANA membership at a later time - $ 0.00

Totals include late and convenience fees...

Naprapathic Practice Act Pledge Contributions

NPA Pledge. If you haven't got a moment to contribute to the NPA pledge ($250), not to worry you may still contribute online here or bring your contributions to the annual event. The Naprapathic Practice Act or NPA pledge continues to fund initiatives in Springfield and now Washington D.C. creating more opportunity for licensed DNs not just in the state of Illinois, but through out the United States.

2023 NPA Pledge Contribution *

I am current with my 2023 NPA Contribution - $ 0.00
I would like to pay my 2023 NPA Pledge Contribution - $ 250.00
I will send / pay my 2023 NPA Pledge Contribution at a later date - $ 0.00

2024 NPA Pledge Contribution *

I am current with my 2024 NPA Contribution - $ 0.00
I would like to pay my 2024 NPA Pledge Contribution - $ 250.00
I will send / pay my 2024 NPA Pledge Contribution at a later date - $ 0.00

Continuing Education Event Confirmation.

After your payment, you should be directed to complete the zoom registration form. Please email ceu@naprapath.org if you do not receive a zoom registration link following your check out.

I understand that this is a virtual CEU event and a certificate of completion is provided upon my successful completion of the live Continuing Education hours and evaluation survey provided by the American Naprapathic Association. I understand that payment alone does not grant a certificate of completion. *

I understand and agree

Signature *

Date *

2024 Virtual Holiday Conference Check Out *

Member - Sunday, December 8, 2024 - $ 154.50
Non-Member - Sunday, December 8, 2024 - $ 206.00

After your payment, you should be directed to complete the zoom registration form. Please email ceu@naprapath.org if you are not redirected to zoom following your check out.

Total

$ 0.00

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Card

Name on Card

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