Begin Registration : Maternal, Newborn, Child and Youth Network

Registrant info

What type of registrant are you?

MNCYN Partner Hospital / Partner Organization Participant Administration Fee

Non-MNCYN Participant Fee

* First Name
* Last Name
* Email Address
* City
* Province / State
* Are you employed by an MNCYN partner hospital, or organization?
	Yes No
* At which MNCYN member hospital (or member organization) are you employed? If you are employed at more than 1 hospital, please select your primary site.

If not employed at any of the sites listed above, please indicate where you are employed.

* Please select your professional designation.

* What is your primary area of practice?
If you chose "other" please explain which area of the hospital your are currently practicing in.