ALEA Assisted Living Education Academy, LLC

Online Class Registration

Please browse through the available classes and once you decide which one(s) you would like to sign up for, please check the appropriate box(es) and then scroll down and fill out the registration form.

SELECT	DATE	COURSE TITLE & INFO		PREFERRED REGISTRATION DEADLINE
	May 7	FIRE SAFETY		5-3-12
		Location:	DeFOREST (MADISON METRO) - Holiday Inn Express, 7184 Morrisonville Road
		Time:	8 am – 12:30 pm
	May 8	STANDARD PRECAUTIONS		5-3-12
		Location:	DeFOREST (MADISON METRO) - Holiday Inn Express, 7184 Morrisonville Road
		Time:	8 am – 10:30 am
	May 8-9	MEDICATION ADMINISTRATION		5-3-12
		Location:	DeFOREST (MADISON METRO) - Holiday Inn Express, 7184 Morrisonville Road
		Time:	May 8th: 11 am – 3:30m May 9th: 8am – 2:30 pm (30 minute lunch break)
	May 10	1^st AID / CHOKING		5-7-12
		Location:	DeFOREST (MADISON METRO) – Holiday Inn Express, 7184 Morrisonville Road
		Time:	8am – 12:30 pm
	May 14	FIRE SAFETY		5-10-12
		Location:	CHIPPEWA FALLS(EAU CLAIRE METRO) – Avalon Hotel, 1009 W. Park Avenue
		Time:	9 am – 1:30 pm
	May 15	STANDARD PRECAUTIONS		5-10-12
		Location:	CHIPPEWA FALLS (EAU CLAIRE METRO) – Avalon Hotel, 1009 W. Park Avenue
		Time:	9am – 11:30 am
	May 15-16	MEDICATION ADMINISTRATION		5-10-12
		Location:	CHIPPEWA FALLS (EAU CLAIRE METRO) – Avalon Hotel, 1009 W. Park Avenue
		Time:	May 15th: NOON – 4:30 pm May 16th: 9 am – 3:30 pm (30 minute lunch break)
	May 17	1^st AID/CHOKING		5-14-12
		Location:	CHIPPEWA FALLS (Eau Claire Metro) – Avalon Hotel, 1009 W. Park Avenue
		Time:	9 am - 1:30 pm
	May 21	FIRE SAFETY		5-17-12
		Location:	WAUSAU – Best Western Midway, 2901 Hummingbird Road
		Time:	9 am – 1:30 pm (30 minute lunch break)
	May 21	FIRE SAFETY		5-17-12
		Location:	MILWAUKEE METRO AREA – Location to be announced
		Time:	8 am – 12:30 pm
	May 22	STANDARD PRECAUTIONS		5-17-12
		Location:	WAUSAU– Best Western Midway, 2901 Hummingbird Road
		Time:	9 am – 11:30 am
	May 22-23	MEDICATION ADMINISTRATION		5-17-12
		Location:	WAUSAU – Best Western Midway, 2901 Hummingbird Road
		Time:	May 22^nd: NOON – 4:30 pm May 23^rd: 9 am – 3:30 pm (30 minute lunch break)
	May 24	1^ST AID / CHOKING		5-21-12
		Location:	WAUSAU – Best Western Midway, 2901 Hummingbird Road
		Time:	9 am – 1:30 pm (30 minute lunch break)
	May 29	STANDARD PRECAUTIONS		5-24-12
		Location:	CHIPPEWA FALLS – Our House Senior Living 115 Marrs Street
		Time:	9 am – 11:30 pm

*DENOTES A REQUIRED FIELD

Participant Information

*First Name: *Middle Initial (or N/A if none):
*Last Name:
*Street Address:
*Street Address 2:
*City:
*State: * Zip Code:
*Last 4 Digits of Social Security Number:
*Complete Date of Birth (mm/dd/yyyy):
*Personal Phone (No Dashes):
*Personal E-Mail:

Facility Billing Information

*Facility Name:
*Street Address:
*Street Address 2:
*City:
*State:
*Zip Code:

Participant Registered By

*Name:
*Title:
*Phone (No Dashes):
*E-Mail:

You will receive a confirmation of these classes within 2 business days.

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1574 W. Broadway, Suite 200 | Madison, WI 53713 | P:(608) 819-2190 F:(608) 819-0666