Conference Registration

  

16th Annual CTOS Meeting

November 11 - 13, 2010
to be held in
Paris, France
at the
Le Meridien Etoile
Please fill out the registration information; (**) denotes required fields.
** First Name
** Last Name
** Institution
Telephone
** EMail
** Specialty
** Street 1
Street 2
** City
** State/Prov.
** Postal Code
** Country
Nickname
Please select one of the following:
 
Member Registration ($500.00)
Non-Member Registration ($700.00)
Fellow/Resident/Allied Healthcare Professional Registration ($375.00)
Member registration after September 17th ($525.00)
Non-Member registration after September 17th ($800.00)
Fellow/Resident (and Other Affiliated Healthcare Professionals) registration after Sept. 17th ($400.00)
Member On-site Registration ($600.00)
Non-Member On-site Registration ($900.00)
Fellow/Resident/Allied Healthcare Professional On-site Registration ($400.00)
Please check all that apply:
 
Attend Wednesday Welcome Reception
Attend Friday Reception/Dinner
Please enter the number of guests who will attend with you:
    Dinner Guest registration ($150.00)
Please enter up to 3 guest names, first & last (if applicable):