WSPMA History and Physical Review Course

Swedish Hospital - Cherry Hill Campus
October 2, 2010

Things to know:

Registration: Up to 3 people can register per form.

Students & Residents: Students & residents can come for free, but must register by September 20th.

Payment: After filling out the form below click "Submit" and proceed to online payment using ANY CREDIT CARD through PayPal

 

Name of First Registrant (As you would like it to appear on your name tag):

Name of Second Registrant (As you would like it to appear on the name tag):

Name of Third Registrant (As you would like it to appear on the name tag):

ALL REGISTRATIONS WILL BE CONFIRMED BY EMAIL
Email:

Registration Fees  
Choose from the following:      
WSPMA Member: $75 x = $    
Non-WSPMA Member: $100 x = $    
Student or Resident: $FREE x    
     
TOTAL Fees: $                   $ ** (please fill in)  
     
** Please write down your total fees - You will need to enter this into PayPal when you pay your fees during the next step.