Registration Form for the Fall 2012 e-CTC Series

Registration Fee $1325

Participation in ALL Sessions is Required. Adobe Connect Sessions are 10am-2pm EST

Session #1: Thursday, September 13, 2012, via Adobe Connect
Session #2: Sunday- Wednesday October 14 - 17, 2012, On site at The Dartmouth Institute:
- Sunday October 14 5pm registration and reception
- Monday October 15, Tuesday October 16 8am - 5:30pm Sessions
- Wednesday October 17, 8am - 1pm.
Session #3: Thursday, November 15, 2012, via Adobe Connect
Session #4: Thursday, December 13, 2012, via Adobe Connect
Session #5: Thursday, January 10, 2013, via Adobe Connect

1 Clubhouse Road

Fairlee, VT 05045

Non-Refundable Registration Fee: $1325/person by check or money order made payable to Trustees of Dartmouth College

Registration fee covers:

Five learning sessions (1 in-person, 4 web-based)
Lecture materials, handouts and workbooks
Individual and group coaching experiences
Accessible and timely academic and technical support
Access to password protected electronic platforms to support learning (Adobe Connect and Clinical Microsystems Intranet)
A life-time membership to the Clinical Microsystems – The Art & Science of Healthcare Improvement professional learning community monthly conference calls.
Certificate of Completion upon completing all program requirements

Additional Fees (not covered in registration fee):

Onsite learning session fees:
- Cost of lodging during onsite session, travel expenses
Required text books (4)
- Quality by Design, Nelson, Batalden, Godfrey, 2007.
- The TEAM Handbook, Third Edition, Scholtes, Joiner, Streibel, 2003.
- Improving Healthcare with Control Charts, Carey, Stake, 2003.
- Helping, Schein, 2009.
Coaching Toolkit

Please mail your check or money order of $1325 to:

Lillian R. Emerson
The Dartmouth Institute Microsystem Academy
30 Lafayette Street
Lebanon, NH 03766

Registration Deadline: August 16, 2012

The eCTC face-to-face meeting will be held at Lake Morey Resort in Fairlee, VT.

Participants must contact Lake Morey Resort to make lodging accomodations.
Rooms rates are available on the Lake Morey Resort website.

Daily Commuter rate: $42.00