Peripheral Nerve Society

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Home PNS Satellite Meeting Meeting Registration

Meeting Registration

Thursday, 11 March 2010 16:19
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Online registration form. The information you enter on this form will be submitted via a secure internet communication channel to the Executive Secretary of the Peripheral Nerve Society. Paypal payment is required. If you prefer to fax or mail your application or pay by check or credit card, please print this form and mail to the address at the bottom of the form. Registration includes the cost of all meals and receptions for meeting participants (except for dinner on the free evening), but not the cost of housing or meals for accompanying persons, which must be arranged separately.

THERE IS NO LATE FEE FOR REGISTRATION! REGISTER NOW!


Member Registration
Member Registration (member in good standing; 2010 dues paid) $700 (US Dollars)
I wish to pay my 2010 member dues at this time $185 (US Dollars)
Postdoc/Trainee Registration $700 (US Dollars)
I wish to pay my 2010 junior member dues at this time $85 (US Dollars)

Non-Member Registration
Non-Member Registration $800 (US Dollars)

Single Day Registration
Monday Only Program Registration $250 (US Dollars)
Monday, July 5th, Evening - Reception, Opera House Northern Foyer $100 (US Dollars)
Tuesday Only Program Registration $250 (US Dollars)
Wednesday Only Program Registration $250 (US Dollars)
Wednesday, July 7th, Evening - Drinks and Dinner, University of Sydney $150 (US Dollars)

Registrant's Name:
Institution:
Address1:
Address2:
City:
State:
Zip:
Country:
E-mail Address:
Phone Number:

Accompanying Person Registration (required for each guest age 12 and above) $250 each (US Dollars). Fee includes full participation in program for accompanying persons, cocktail party, banquet and all other meeting activities except scientific sessions.

Guest Names:


Please indicate your attendance for the following events (included in meeting registration): Monday, July 5, Evening - Reception, Opera House Northern Foyer
Wednesday, July 7, Evening - Drinks (University Quadrangle and Nicholson Archeological Museum) and Dinner (McLauren Hall, University of Sydney)

Total



For additional information contact:
Amber Millen
PNS Executive Secretary
UCSD - Anesthesiology (0629)
University of California, San Diego
9500 Gilman Drive, MTF 445
La Jolla, CA 92093-0629
1-858-534-3865
1-858-534-1445 (Fax)
Last Updated on Thursday, 10 June 2010 15:18