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the USLCA recorded webinar order form

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<strong>USLCA</strong> Recorded Webinar Order Form<br />

Please indicate which <strong>webinar</strong>s you would like to <strong>order</strong> by checking <strong>the</strong> box beside each of <strong>the</strong> <strong>webinar</strong> titles. Make sure<br />

you check off if you will be <strong>order</strong>ing a CD for an individual, a group of 3-10, or a group of 11 or more. Beside ‘Quantity’,<br />

please indicate how many of each CD you would like to <strong>order</strong>.<br />

Prices are as follows unless o<strong>the</strong>rwise noted by <strong>the</strong> <strong>webinar</strong> title:<br />

1hr <strong>USLCA</strong> Members $20, Non-members $30, Groups of 3-10 $55, Groups of 11 or more $75<br />

(Make sure you indicate which type of CD you will be <strong>order</strong>ing by checking <strong>the</strong> appropriate box)<br />

<strong>USLCA</strong> Chapters receive a discount on group <strong>order</strong>s. All Group Webinar CDs for chapters are <strong>the</strong> price listed for <strong>the</strong><br />

group of 3-10.<br />

Ethics Webinars good for E CERP<br />

1. □ 1 hr. August 6, 2009 “Code of Ethics: Time to practice what you preach?” by Amy Spangler, MN, RN, IBCLC, RLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

2. □ 1 hr. January 14, 2010 "The Code, Companies, and LC's" by Marsha Walker, RN, IBCLC, RLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

3. □ 1 hr. June 9, 2010 "The Golden Rule: Ethics for IBCLCs" by Diane Wiessinger, MS, IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

4. □ 2 hr. September 25, 2012 “Are we being ethical? Navigating ethical dilemmas” by Marsha Walker, RN, IBCLC”<br />

Please note that this <strong>webinar</strong> is 2 hours and is worth 2 E Cerps. Pricing tier is as follows:<br />

<strong>USLCA</strong> Members $30, Non-members $40, Groups 3-10 $65, 11 or more $85<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

5. □ 1.5 hr January 16, 2013 “Ethics: Guilty or Not Guilty?” by: Amy Spangler, MSN, IBCLC, RLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

Lactation Specific Webinars good for L CERP<br />

1. □ 1 hr. June 27, 2009 "Making <strong>the</strong> Breastfeeding Decision: How to Not Make it a Guilt Trip” by Glenda Dickerson,<br />

RN, MS, IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

2. □ 1 hr. November 18, 2009 "Clinical Education: The breastfeeding surgical client" by Deb Dumphy RN, MS, IBCLC,<br />

RLC, FNP-S<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more


3. □ 1 hr. February 18, 2010 "Caring for <strong>the</strong> Late Preterm Infant: Are <strong>the</strong> ‘Expert’ Recommendations Really Valid?”<br />

by Molly Pessl, BSN, IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

4. □ 1 hr. March 16, 2010 "Working and Breastfeeding: Helping Our Mo<strong>the</strong>rs" by Cathy Caro<strong>the</strong>rs,<br />

BLA,IBCLC,RLC,FILCA<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

5. □ 1 hr. April 6, 2010 "Research into Practice: Integrating New Latch Techniques" by Cathy Watson-Genna, BS,<br />

IBCLC (Repeat of <strong>the</strong> January 20, 2010 <strong>webinar</strong> listed above)<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

6. □ 1 hr. May 19, 2010 “Fore-Milk Hind-Milk Imbalance: Signs, Symptoms & Interventions” by Ellen Lechtenberg<br />

RD, CD, IBCLC, CSP<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

7. □ 3 hr. April 28, 2010 "Assessment and Treatment of Tongue-tie" by Alison K. Hazelbaker, PhD, IBCLC, RLC<br />

Please note that this <strong>webinar</strong> is 3 hours and is worth 3 L Cerps. Pricing tier is as follows:<br />

<strong>USLCA</strong> Members $40, Non-members $55, Groups 3-10 $80, 11 or more $105.00<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

8. □ 1 hr. August 25 th 2010 “Becoming Baby Friendly” by Anne Merewood, MA, MPH, IBCLC, RLC and Gina Wall, RN,<br />

MN, IBCLC, RLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

9. □ 2 hr. November 30, 2010 “Choosing and Using Breastfeeding Tools" by Cathy Watson-Genna, BS, IBCLC<br />

Please note that this <strong>webinar</strong> is 2 hours and is worth 2 L Cerps<br />

<strong>USLCA</strong> Members $25, Non-members $40, Groups 3-10 $65, 11 or more $85<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

10. □ 1 hr. January 19, 2011 “Mentoring Our Future” by Denise Altman, RN, IBCLC, LCCE<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

11. □ 1 5 hr.. February 16, 2011 "Swaddling: A Historical, Cultural, and Lactational Perspective” by Linda Smith, BSE,<br />

FACCE, IBCLC, FILCA<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

12. □ 6 hr. March 21, 2011 "Help for <strong>the</strong> Hospital-based Clinician “<br />

Please note that this <strong>webinar</strong> is 6 hours and is worth 5 L Cerps and 1 E Cerp. Pricing tier is as follows:<br />

<strong>USLCA</strong> Members $65, Non-members $95, Groups 3-10 $250, 11 or more $400.00<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

13. □ 1 hr. April 19, 2011 “Mo<strong>the</strong>r-infant sleep location and nighttime feeding behavior: Where do babies sleep?” by<br />

Kathleen Kendall-Tackett, Ph.D., IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

14. □ 1 hr. May 25, 2011 "Tits, Tats, and Piercing's" by Robyn Roche-Paull, BS, IBCLC, RLC<br />

__ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more.<br />

15. □ 1.5 hr. October 12, 2011 "Jaundice in <strong>the</strong> Breastfeed Infant" by: Dr. Lawrence M. Gartner, M.D., FAAP<br />

Please note that this <strong>webinar</strong> is 1.5 hours and is worth 1.5 L Cerps<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more


16. □ 1 hr. December 1, 2011 "Human-milk sharing: getting a grip on a fast-evolving reality" by James Akre , BA,<br />

MPIA<br />

__ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more.<br />

17. □ 2 hr. February 9, 2012 “Treating Breastfeeding Problems with Craniosacral Therapy” by: Alison Hazelbaker,<br />

PhD, MA, IBCLC Please note that this <strong>webinar</strong> is 2 hours and is worth 2 L Cerps<br />

<strong>USLCA</strong> Members $30, Non-members $40, Groups 3-10 $65, 11 or more $85<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

18. □ 8 hr. February 18, 2012 “Texas Breastfeeding Summit Improving Exclusive Breastfeeding Rates in <strong>the</strong> Hospital<br />

Setting" Please note that this <strong>webinar</strong> is 8 hours and is worth 8 L Cerps Individual Price is $140.00 (a portion of<br />

<strong>the</strong> proceeds are sent to <strong>the</strong> San Antonio Breastfeeding Coalition)<br />

19. □ 1 hr. April 24, 2012 "Prenatal Expression of Colostrum" by Sue Cox, AM, BMid, IBCLC, FILCA<br />

__ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more.<br />

20. □ 1.5 hr. May 7, 2012 “Breastfeeding <strong>the</strong> Older Baby and Tandem Nursing” by: Diana Cassar-Uhl, IBCLC<br />

Please note that this <strong>webinar</strong> is 1.5 hours and is worth 1.5 L Cerps<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

21. □ 6 hr. May 22, 2012 “Lactation Foundations Revisited”<br />

Please note that this <strong>webinar</strong> is 6 hours and is worth 6 L Cerps and. Pricing tier is as follows:<br />

<strong>USLCA</strong> Members $65, Non-members $95, Groups 3-10 $250, 11 or more $400.00<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

22. □ 1 hr. July 19, 2012 " Complementary and Alternative Therapies in Breastfeeding " by Nikki Lee, RN, BSN, MS,<br />

IBCLC, CCE, CIMI, ANLC, CKC<br />

__ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more.<br />

23. □ 2.5 hr. August 20, 2012 " Breastfeeding Should be Fun and Enjoyable: A Discussion on Why Tongue and Lip<br />

Ties can cause Breastfeeding Problems " by Dr. Lawrence Koltow, D.D.S<br />

Please not that this <strong>webinar</strong> is 2.5 hours and is worth 2.5 L Cerps. Price tier is as follows<br />

<strong>USLCA</strong> Member $30, Non-member $40 Group 3-10 $65 Group of 11 or More $85<br />

__ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

24. □ 6 hr. November 8, 2012 “Enriching Hospital Support of Breastfeeding”<br />

Please note that this <strong>webinar</strong> is 6 hours and is worth 6 L Cerps and. Pricing tier is as follows:<br />

<strong>USLCA</strong> Members $65, Non-members $95, Groups 3-10 $250, 11 or more $400.00<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

25. □ 2 hr. November 29, 2012 “Sustaining Exclusive BF for 6 months: realistic or not?” by: Linda J. Smith, MPH,<br />

FACCE, IBCLC, FILCA. Please note that this <strong>webinar</strong> is 2 hours and is worth 2 L Cerps<br />

<strong>USLCA</strong> Members $30, Non-members $40, Groups 3-10 $65, 11 or more $85<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

26. □ 1.5 hr December 12, 2012 "Babies who can’t, won’t or don’t take <strong>the</strong> breast, paradigms and solutions" by:<br />

Christina Smillie, MD, FAAP, IBCLC, FABM. Please note that this <strong>webinar</strong> is 1.5 hours and is worth 1.5 L Cerps<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

Related Specific Webinars good for R CERP<br />

1. □ 1 hr. May 18, 2009 “Connect-Encourage-empower-One Woman at a Time” presenter Pat Farrell, LLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more


2. □ 1 hr. December 8, 2009 "The Role of <strong>the</strong> Breastfeeding Fa<strong>the</strong>r" presenter Tom Johnston, CNM, IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

3. □ 1 hr. June 9, 2011 "Teaching <strong>the</strong> Oxytocin-Enriched Brain: Getting it "Right" so Moms Can Hear You" by Dawn<br />

Kersula, RN,FACCE, IBCLC<br />

___ Quantity □ Individual □ Group of 3-10 □ Group of 11 or more<br />

Webinars with Cerps Not Offered:<br />

1. □ 1 hr. August 16, 2012 “Reimbursement 101” by Gini Baker, RN, MPH, IBCLC, Judith Gutowski BA, IBCLC<br />

Cerps not offered for this <strong>webinar</strong>. Shipping and Handling fee is $10.00 members and 35 for Non –<br />

Members.<br />

2. □ 1 hr. August 23, 2012 “Getting Started with Aetna” Speakers: Shannon Montgomery and Jenee Dederichs<br />

Cerps not offered for this <strong>webinar</strong>. Shipping and Handling fee is $10.00 members and 35 for Non –<br />

Members.<br />

3. □ 1 hr. October 25, 2012 “Marketing Imperatives for IBCLCs” by: Bettina Forbes, CLC & Danielle Rigg, JD, CLC<br />

Cerps not offered for this <strong>webinar</strong>. Shipping and Handling fee is $10.00 members and 35 for Non –<br />

Members.


Please submit this <strong>form</strong> with payment and <strong>the</strong> above <strong>order</strong> <strong>form</strong>. We will not process incomplete <strong>order</strong> <strong>form</strong>s.<br />

Name: ___________________________________<br />

Email: _______________________________<br />

Address: ______________________________________<br />

Phone: __________________________<br />

City: ________________ State: __________<br />

Zip Code: _____________<br />

If you would like to send a check, fill out <strong>the</strong> in<strong>form</strong>ation below and please mail payment to:<br />

Check #_______ Amount on Check: _______<br />

<strong>USLCA</strong> Webinar<br />

2501 Aerial Center Parkway, Ste. 103<br />

Morrisville, NC 27560<br />

If you would like to pay with a Credit Card please complete <strong>the</strong> below in<strong>form</strong>ation:<br />

Type of Credit Card: □ Visa □ Master Card<br />

Credit Card Number: __________________________________<br />

Expiration Date: ____________ 3 digit CVC code: __________________<br />

I authorize <strong>the</strong> <strong>USLCA</strong> to charge my Credit Card ___________ as payment for <strong>the</strong> <strong>webinar</strong><br />

Signature: _____________________________________________________________________<br />

If you are <strong>order</strong>ing for your chapter please list <strong>the</strong> Chapter name below<br />

________________________________________________________________________________<br />

Please submit this <strong>form</strong> and your payment by any of <strong>the</strong> ways listed below:<br />

Fax: 919-459-2075 Email info@uslca.org<br />

Mail: <strong>USLCA</strong> Webinar, 2501 Areal Center Parkway Ste. 103, Morrisville, NC 27560

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