Mountain Plains Health Consortium
On-Line Registration

If the workshop you want is not listed, please call or email MPHC to inquire about registration. Information is required in all blanks followed by an asterisk.
heds@heds.org       phone: 605-720-7117 

Class/Workshop Title (Select the desired Class/Workshop from the drop-down menu):    
Access I Advanced IV Certification for LPN's Advanced Supervision Basic Supervision EMT Basic Refresher EMT Intermediate Refresher EMT Paramedic Refresher Excel I Excel II Expanded Role: IV therapy for LPNs Facilitator: Train the Trainer Healthcare Security Training IHS SDD Planning Meeting Infection Control Outlook PowerPoint QHCF Skin and Wound Care Stress Management I & II Windows Word I Word II *

Starting Date of Workshop/Class (example:  10/23/00):    *
Workshop/Class Location (example:  Fort Meade, SD)    *
Aberdeen Alliance Bismarck, ND Colville, WA Camp Rapid - Rapid City Casper Cheyenne Eagle Butte Fort Meade Fort Yates Gillete Gordon Green River Hot Springs Jackson Lander NewCastle Pierre Pine Ridge Rapid City Riverton, WY Rock Springs Sheridan Sidney Sioux Falls Sioux San Sisseton Thermopolis Towaoc, Co

                      First Name:    *
       Middle Name/Initial:    (Optional)
                      Last Name:    *
   Facility (place of work):     *
                        Address (mailing):   *
                              City (mailing):    *
                            State (mailing - use two letter abbreviation):  *
                      Zip Code (mailing):    *
   Telephone (best number to contact you - include area code):  *

Number Attending: (If just yourself, enter 1 - If representing group, enter number in your group including yourself)
*
Please go over the information before clicking the submit button since an error will require you to fill out the form again and resubmit it. Thank You.