Louisiana State University Health Sciences Center Administration & Finance
 


CLPC Registration Form - For Distance Learning ONLY

These seminars, sponsored by the Clinical Laboratory Personnel Committee (CLPC),  are available free of charge ONLY to individuals who hold a current Louisiana license. Each full-day seminar  provides 6.0 contact hours. Individual sessions provide 1.5 contact hours each.   A current license number listed on the registration form is required to register for any of the seminars.

Registration is limited to only ONE city. Please select the city in which you would like to attend the seminar and list it on the registration form below. You may attend one or more sessions at that site. Applications will be handled on a first come, first served basis.  If the site you choose is full, you will be notified by email. 

Please COPY the registration form below, PASTE it into an email, complete the form  and email it to ahcls@lsuhsc.edu.  You will receive confirmation of registration by email.

YOU CANNOT TYPE ON THE FORM BELOW UNTIL YOU COPY AND PASTE IT INTO AN EMAIL.

Thank you. 

Click here for a link to the Distance Learning city sites

PLEASE PRE-REGISTER EARLY.  You can always cancel if you are unable to attend. No one is registered until the email registration form below has been sent to the email address above and a confirmation form has been sent back via email.  Registration forms received only a day or two before the seminar may not be confirmed due to time constraints. Cities with no one pre-registered one week prior to the seminar will be cancelled and walk-ins will not be honored.

CLPC Registration Form
In the right hand column, fill in the blanks as appropriate. 
When given a choice, place an X before your choice or delete the ones that do not apply.

Name: (REQUIRED)

 

State License Number: (REQUIRED)

 

License Type ___CLS-G___CLS-T___CLS-S___Phleb

___Lab Asst___Cyto
License Expiration date:  
Email Address:

 

Daytime Telephone Number:

 

Place of Employment:  

Seminar Date:

 

Distance Learning Seminar City. 
List the site, if more than one site per city.

 
Which session(s) do you wish to attend : ___1st  ___ 2nd   ___ 3rd  ___ 4th  ____  All