Surgery Symposium - participant registration form

On Sunday, April 25, 2010 we will be hosting a symposium on surgical procedures. Continuing Education credits for both doctors and technicians are pending approval.

6 hours of continuing education credits are anticipated.
Registration will begin at 7:30 am (breakfast, lunch and snacks will be served).
Lectures are anticipated to end around 4:30 pm.
The Surgery Symposium is open to Doctors, Technicians, Students, Residents & Interns.

When: Sunday April 25, 2010

Location: Marriott Boston/Peabody
8A Centennial Drive, Peabody, MA 01960

Time: 8:30 am - 4:30 pm

7:30 am registration begins

CE Credits: 6

Prices:

Doctors: Before April 1, 2010: $125
(Register early for early bird pricing! $150 after 4/1)

Technicians: Before April 1, 2010: $100
(Register early for early bird pricing! $125 after 4/1)

Residents & Interns: Before April 1, 2010: $65
(Register early for early bird pricing! $90 after 4/1)

Vet Tech Students & Veterinary Students: Free

Please pay with paypal (link below) or make checks payable to InTown Veterinary Group

Contact Information

Full Name

Full Name: *

Credentials

The letters following your name - e.g. DVM, VMD, CVT, etc.

Address

Hospital Name: *

Street Address *

Address continued

City *

State *

Zip *

Phone Number

Email Address *

We will use your email to send you reminders, notifications & updates.

Residents, Interns & Students:

Name of Residency Programme or Internship (if you are a resident or intern):

Name of Tech or Vet School (if you are a student):

How did you hear about the Surgery Symposium?

How did you hear about the Surgery Symposium? * FaxEmail from InTown Veterinary Group WebsiteCE Listing on the InTown Veterinary Group WebsiteCE Listing in a national publicationCE Calendar in a VMA publication or websiteOther

If you answered "national publication" please tell us which one.

If you answered Other, please tell us where.