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YES, I will be attending the 2008 Southern
States Rhinology Course
General Lecture and Laboratory- $1500 ($1700 after March 15)*
Lecture Only - $1000 ($1200 after March 15)
Lecture Only (Residents) - $500 ($700 after March 15)
* Space limited for lab participation. As of January 15, 2008,
there are no resident laboratory spaces available.
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The Lab Section of the course will take place on
Saturday, April 12. Please choose from the following options: |
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I would like to sign up for the morning lab
session**.
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I would like to sign up for the afternoon lab
session**.
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I would like to have IGS at my lab station**.
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** Lab session preference and IGS will be available on
a first come, first serve basis. You will be notified via email of your
actual lab assignment and whether or not you will have IGS at your
station. IGS is NOT available at resident lab stations.
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Name
(req.) |
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Practice/Company |
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Are you a resident? |
Yes
No |
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Address |
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City, State
Zip |
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E-mail
(req.) |
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Office
Phone |
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Mobile
Phone |
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Fax |
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Guest/Spouse Name |
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YES, I/we will attend the Thursday
evening cocktail party
Number attending
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YES, I am interested in playing golf with other
attendees and/or exhibitors. I understand that the tee time will be
made in my name, and I will be responsible for all
charges and
cancellation policies.
Name:
Handicap:
Name:
Handicap:
I
want to play Thursday afternoon.
I
want to play Friday afternoon.
Please indicate a course preference (Ocean
Course,
Turtle Point,
Osprey Point,
Oak Point,
Cougar Point)
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PAYMENT |
Total $
After you submit this registration, a
link will appear to pay with a credit card via PayPal online. If you
would prefer to pay with a check, please mail it in with the PDF invoice
(linked on next page) in order to
complete this registration. |
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ADDITIONAL COMMENTS |
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This registration will go directly
to Tara Morrison, the SSR Executive Director. If you have any
questions, you can contact her at 770-613-0932 or tara@theassociationcompany.com
And don't forget to make your room reservation,
(800) 576-1570. |
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