Name
*
Phone
*
Email
*
Organization
*
Title
*
ARE YOU A CURRENT ACHE MEMBER?
*
Yes
No
IS THIS YOUR FIRST GROUNDHOG DAY EXPERIENCE?
*
Yes
No
IF NO, HOW MANY YEARS HAVE YOU PARTICIPATED?
*
How many students are you willing to take?
*
Area(s) of Interest
*
Compliance/Legal/External Affairs
Finance
Information Technology
Long-Term Care
Medical Group Management
Operations
Process Improvement
Strategy/Planning/Business Development
Supply Chain
Third-Party Payors/Insurers
Other
If other, please describe.
*