1. The and the
National Association of Social Workers (N.A.S.W.),
Gerontology - Special Interest Group (SIG) - New Orleans Region
invite you to participate in a
VENDOR FAIR FOR SOCIAL WORKERS,*
DISCHARGE PLANNERS & CASE MANAGERS
Wednesday, June 15, 2011
East Jefferson General Hospital
Conference Center - Esplanade Rooms I & II
4200 Houma Blvd, Metairie
5:00pm - 7:00pm (set up begins at 4:30pm)
*approved CEUs for Social Workers. (Small fee for non-NASW members)
REGISTRATION FORM FOR VENDORS Please fax to 504-828-4985 or email to
Louisiana@SeniorDirectory.com
Today’s Date: _______________ Company Name: ______________________________________
Contact Person: __________________________________________
Address: ________________________________________________
City: _______________________________ Zip: ______________
Phone: _______________________ Fax: ______________________
Email address: ___________________________________________
Check both boxes and bring both of the following: Plates, utensils, cups & napkins
will be provided.
□ Yes, I will bring a door prize valued at $25.00 or more, AND
□ Entry Fee (check one): □ Small Tray of Finger Sandwiches
□ Veggies & Dip □ Cheese & Crackers
□ Chicken wings

2. □ 12-pack of Iced Soda Pop
□ 12-pack of Iced Individual Water Bottles
□ Fresh Fruit Tray