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Meeting Registration Form: Advances in First Trimester Ultrasound Imaging May 31 - June 2, 2018 • The Bellagio® • Las Vegas, Nevada OBGYN18 TUITION: LIVE MEETING TUITION: LIVE WEBCAST �� Physicians �� Scientists �� Company Personnel �� Fellows / Residents* ����Full Time Military* ����VA Physicians* ����P.A./R.A. ����Retired Physicians ����Technologists Name �� M.D. �� D.O. �� Ph.D. �� R.T. �� P.A./R.A. �� RDMS �� Other Company / Hospital Specialty Group Practice Name Address City / State / Zip / Country Phone Email (REQUIRED FOR ELECTRONIC SYLLABUS) Card Number Exp. Date Security Code Billing Address City / State / Zip / Country Cardholder Signature ����$995 ����$498 ����$595 ����$995 ����498 ����$595 ����$1,095 ����$598 ����$695 ����$1,095 ����$598 ����$695 �� ADD Printed Color Syllabus $95 Advanced Purchase Only �� ADD Printed Color Syllabus $95 Advanced Purchase Only Please check your selection below: INCLUDES ELECTRONIC COLOR SYLLABUS Check Meeting Registration below: INCLUDES ELECTRONIC COLOR SYLLABUS On or Before 5/21/18 After 5/21/18 On or Before 5/21/18 After 5/21/18 REGISTER ONLINE: WWW.EDUSYMP.COM Attendance is limited; therefore, early registration is strongly suggested. 4 EASY WAYS TO REGISTER We Accept FAX (813) 806-1001 PHONE (813) 806-1000 SECURE CHECKOUT INTERNET www.edusymp.com MAIL Check payable to: Educational Symposia 5620 West Sligh Avenue Tampa, Florida 33634-4490 Reduce your mail clutter or just add email announcements. Please visit the “Mailing List” section of our website at www.edusymp.com. 50% OFF There will be a $100 surcharge for anyone registering after May 21, 2018. *MUST ENCLOSE OR FAX LETTER FROM YOUR DIRECTOR CERTIFYING STATUS.


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