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MILE

Limited Time Offer
Register today and pay
US$ 2500 only

Offer ends on 31st March, 2013

Program Fees

Program Investment Before March 1st , 2013 After March 1st , 2013
One day master class US$ 700 US$ 850
One day master class
+ Conference
US$ 1500 US$ 1700
Conference Only US$ 800 US$ 950
Full Program (5 Days) US$ 3500 US$ 4200


High Performing Healthcare Organizations

 Fill Out The Application Form 
Choose one option
One day master class
One day master class + Conference
Conference Only
Full Program (5 Days)
Prefix / Title:*
First Name:*
Middle Name:
Last Name:*
Preferred Badge Name:
Upload Your Image:
Birth Date:*
Gender:* Male
Nationality:*
Personal Email:*
How did you hear about us?*
 Contact Information 
  Address  
  Postal Code  
  City *  
  Country *  
  Mobile Number *
(Including the Country Code)
 
  Work Telephone
(Including the Country Code)
 
  Home Telephone  
  Fax  
  Work Email *  
  Personal Email *  
  (A secondary email such as yahoo, Gmail or hotmail in case if we experience problems sending to your work email.)  
  LinkedIn Profile
(i.e.www.linkedin.com/companies/629994)
 
  Facebook Profile
(i.e.www.facebook.com/milemadinah)
 
  Twitter Profile
(i.e.www.twitter.com/milemadinah)
 
       
 Employment Details  
  Name of Employer: *    
  Employer Website:    
  Industry:    
  Number of employees in the entire organization:    
  Job Title: *    
  Years: *
Number of years in the Current Position
   
  Who will pay the fee?   MySelf   My Company    
         
 I have filled this application form to the best of my knowledge and I declare that the statements made in this application are true.  
         
   
         
 

HPHO program concluded on April 10th 2013. Stay tuned for the announcement of HPHO 2.