Healthy Children's Courses and Conferences

AILP Registration Form

First Name:^*
Middle Initial:
Last Name:^*
Organization:

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PO Box / Mail Stop:
Primary Address:^*
City:^*
State:^*
Zip:^*
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Phone 1:^*	ext.
Phone 2:	ext.
Email:^*
Fax:

Continuing Education Credit

RN License #:
RN License State:
IBCLC #:
IBCLC Exam Year:

Registration Information

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Class Tuition

Regular Tuition (per person)
$655 (US)	Regular Tuition
$575 (US)	Early Bird ^**
Group / Agency Rate Tuition^***
$605 (US)	Regular Tuition
$525 (US)	Early Bird ^**
Agency:

** Early Bird: An early registration discount of is available if your check or credit card information is received 4 weeks (28 days) prior to the beginning of the training.

*** A group discount is available when 4 or more people from the same agency register and identify themselves as part of that agency. The group must be identified at the time of registration. Group discounts will not be given retroactively.

Application and Exam Fees

The Advanced Lactation Consultant / Advanced Nurse Lactation Consultant ® Exam is administered by the
Academy of Lactation Policy and Practice (ALPP)

This course leads to eligibility for the ALPP Advance Lactation Consultant (ALC) Exam or the ALPP Advanced Nurse Lactation Consultant (ANLC) Exam. If you are an RN who will be sitting for the Advanced Nurse Lactation Consultant (ANLC) certification, please make sure you entered your RN License number above on this registration form. ALPP will need your RN License number and a copy of your license to confirm that you are eligible for the ANLC Certification.
$120 (US)	ALC/ANLC Exam Fee (includes $20 Application Fee)
$0 (US)	Not taking the ALC/ANLC Exam

Textbook

The following books will be used during the course and for homework. Participants may share books. The textbooks can be purchased as you register, or later through Health Education. All prices below include shipping to the Primary Address listed above.

$35.75 (US)	Case Studies in Breastfeeding: Problem Solving Skills and Strategies
$0 (US)	No Case Studies

$55.75 (US)	Maternal and Infant Assessment for Breastfeeding and Human Lactation, 3rd Ed. Problem Solving Skills and Strategies
$0 (US)	No MINA Book

$75.75 (US)	Pocket Guide for Lactation Management, 4th Ed. Problem Solving
$0 (US)	No Pocket Guide

Prerequisites

	I understand I must be a current Certified Lactation Counselor (CLC®) or current IBCLC*. In addition, I agree I must have completed Healthy Children's Maternal Infant Assessment for Breastfeeding and Human Lactation Course within the last two years. I authorize ALPP to share my CLC status with the Center for Breastfeeding upon request.
*IBCLCs please send your certification to info@centerforbreastfeeding.org

Notes

Payment Information

We are unable to hold a place for you without payment or a purchase order number.
If you are paying by credit card, please provide the address and information
associated with the credit card.

My Billing information is the same as above

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$25 per person surcharge for POs / bill your agency

***The verification # is the 3 digit number on the back of your MC/VISA/Discover, or 4 digit number on the front of your AmEx.

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Advanced Issues in Lactation Practice