[Registration] 2020 PsA Dinner Series : Houston PsA Dinner Series – Houston Registration Form Monday, March 2nd Registration: 6:30 PM Dinner: 7:00 – 8:30 PM Fogo de Chao Brazilian Steakhouse 8250 Westhemer Rd Houston, TX 77063 Faculty: Barbara Kienzle, BSN, RN Step 1 of 3 33% Name* First Last Credentials*RN, NP, PA, etc | If you are industry, please put N/A | Students with no credentials please enter "student" here.Mobile*Email* Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Company NameJob TitleWork Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work Phone Are you a student or recent graduate?* Yes No If yes, what school are you associated with?Are you interested in a career in rheumatology?* Yes No How did you hear about this event? Select all that apply.* Facebook Twitter Instagram LinkedIn Email Mailer Phone Call RNS Website Event where RNS Exhibited Are you interested in joining a chapter of the RNS?* Yes No Δ