1. Houston, TX June 25-26, 2016 Brought to you by: American College of Cardiovascular Nurses, American Board of Cardiovascular Medicine, and Memorial Hermann Health Systems Alice Friedrich, ANP, MS, BSN, RN, CVRN-BC Level II, MACCN - Alice currently works as a Cardiovascular Nurse Practitioner for the North Shore LIJ Health System in New York. Alice was among the first Nurse Practitioners to receive CVRN Board Certification Status in 2000. Alice comes to you with a phenomenal amount of Essential Knowledge and Clinical Expertise to assist you in the Diagnosis and Management, and Daily Care of Cardiovascular Patients with a host of Cardiovascular Anomalies. A frequent speaker at ACCN courses on a National level. Alice receives rave reviews at all of her events. Join her in this highly interactive Course. Memorial Hermann Hospital is taking the lead in the Houston area, by hosting a Clinical Cardiovascular Nursing Review Course and CVRN Board Certification Opportunity for their Cardiac Nurses, Nurse Practitioners, and those throughout the region at other Hospitals and Clinics who wish to take part in this Professional Development event. This Clinical Cardiovascular Nursing Course was designed to meet the Professional Development and Board Certification needs of Cardiac Nurses and Nurse Practitioners working in PCU, Telemetry, Emergency Chest Pain Centers, Cardiovascular Critical Care, Cath Lab, CV Surgery, CV Recovery, Cardiac Rehab, and Private Practice Cardiology Offices and Clinics. If your hospital is seeking or needs to maintain Magnet Status, the Board Certification Exams offered by the American Board of Cardiovascular Medicine are approved by the ANCC for Magnet applications. Elevating the Standard of Cardiac Care on a Global Scale! MEDICAL PLAZA NORTH

2. Course Outline: Saturday June 25 th, 2016 7:00-7:55am - Course & Exam Registration Topics of the day: 8:00am to 5:00pm EKG Essentials Pacemakers ACS Bedside Assessment Hypertension Course/Exam Outline: Sunday June 26 th, 2016 7:30-7:55am - Course & Exam Registration Topics of the day: 8:00am to 12:00pm Heart Failure Cardiomyopathy Interventional Cardiology 2:00-5:00pm – CVRN Board Certification Exams Registration Fees and Instructions for the Cardiovascular Nursing Review Course and/or Certification Exams: 1) Memorial Hermann Hospitals System Wide: $120 Course Only; and an additional $220 for the CVRN I Exam (the CVRN II Exams will also be available onsite for those who already hold a level I certificate, for $150. 2) All Non-Memorial Hermann Hospitals System Staff Fees: $180 Course Only; and an additional $295 for CVRN I Exam A Pre-Registration fee of $120 is required for the Course only and it must be paid by June 15 th, 2016 to reserve your seat and avoid late fees of $20. Any registrations received after this date will be assessed a $20 late fee and will be considered a walk-in registrant. Contact Hours: This course is approved for 7.0 contact hours for 6/25/16 and an additional 4.0 hours for 6/26/16 by the Florida Board of Nursing Provider Number 50-14076. Course Location: Memorial Hermann Health System, Medical Plaza North, Piney Point and Bunker Hill Conference Rooms, 920 Frostwood Drive Houston, TX 77024 Questions about the Course and Exams Call 352-293-3131 (9am-4pm M-F) or email jenragan8@tampabay.rr.com or jcooper@accn.netjenragan8@tampabay.rr.comjcooper@accn.net Terms and Methods of Payment: Every one must pay at least the course registration fee by June 15 th, 2016 in order to reserve a seat in this course and exam site without penalty. Be sure to call or email for availability after this date. 1) To pay by credit card, visit us online under Conferences then to Cardiac Nurses at www.accn.net and find this conference.www.accn.net 2) To Pay by check or money order, make payable to ABCM (may combine Course and Exam fees in one, or separate checks) and mail along with the Registration Form on the next page to: ABCM, P.O. Box 1285, Ruskin, FL 33575. 3) Do not mail your Course Registration fee after June 10 th, 2016, to ensure that we receive it by June 15 th. If you register after June 15 th, please email us to be sure there are available seats and we will confirm by email, keeping in mind the earlier you register the more likely you will have a seat as these popular courses fill up very rapidly in the Houston area. 4) If you are undecided about the Exam, you may wait to pay for it onsite with cash or check. 5) Please fill out the application on the next page and email, mail, or bring it to the course with you and turn it in as you sign in.

3. Register for the Cardiovascular Nursing Review Course and/or the CVRN-BC Exam: Scheduled for Houston, TX – June 25-26, 2016 Please do not leave any questions un-answered, or your registration will not be complete. Print clearly in your best handwriting.  I will attend the Cardiovascular Nursing Review Course  I will sit for my CVRN Level I Board Certification Exam at the completion of the Course  I am undecided about taking the CVRN Level I Board Certification Exam and will let you know onsite at the Course. 1. First name: ______________________Middle initial: _____ Last name: ____________________________ 2. Degree(s) Held: _______________________________________________________________ 3. Professional certifications held: __________________________ 4. Nursing or other Professional License Number & State Issued: _____________________________ 5.  Male  Female 6. Home address: ____________________________ City: __________________ State:_________ Zip: ________ 7. Home email:___________________________________ 8. Work email: ___________________________________ 9. Home phone: ______________________ 10. Supervisor’s Name: ______________________________________ 11. Name of Employer: ______________________________________ 12. Phone number of Employer: ________________________________ 13. What area of cardiology do you work in? ______________________ 14. How long have you worked in this area? ________________ 15. What other areas of cardiology do you have experience in? ____________________________________________ 16. How many hours per week do you work in cardiology? ________ 17. Have you had formal training in cardiology? __________ 18. If so, what specialty degree or certification do you hold in cardiology? ___________________________________ 19. Does your hospital have an in-house training program for cardiovascular critical care and telemetry nurses? _______ 20. Does your hospital have an in-house training program for cardiac monitor and EKG Techs? ____________ 21. Is your hospital a Magnet facility or are they seeking Magnet status? ______