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27th Conference Registration

Please print this page and mail as indicated below:

REGISTRATION:

27TH ANNUAL CQIA CONFERENCE ON

QUALITY AND INNOVATION

Tuesday, JUNE 24, 2021

9:45 am TO 2:15 pm

Saint Clements Castle in Portland, CT

Registration fee covers continental breakfast, seated networking lunch, 2014 Connecticut Best Practices Book, 2014 CQIA Innovation Prize plaques, and photographs.

_______ Please register me for the Conference. Attached is a check (no purchase orders) made payable
to Connecticut Quality Improvement Award for $65 (price reduced for 2014).  Bring a friend.

_______ Please register me for the Conference and bill my MasterCard, VISA or
American Express card for $70 (price reduced for 2014).  Bring a friend.

FOR EACH PERSON ATTENDING:

Name ______________________________________________

Title _______________________________________________

Organization _________________________________________

Mailing Address _______________________________________

Telephone ___________________________________________

Email _______________________________________________

Card number ____________________________ Expiration ______

Mail to CQIA Innovation Prize
1127 High Ridge Road #292, Stamford, CT 06905

The Connecticut Quality Improvement Award Partnership, Inc. and its CQIA Innovation Prize are 501(c) (3) not for profit Connecticut organizations receiving no operating money from either state or federal government.  All funding comes from Sponsors, application fees and conference registration.