Perspectives in Men's Health

April 9-11, 2010
Caesar's Palace
Las Vegas, NV

Please complete the following information.
If you are registering more than one person, you will need to complete this form and make payment separately for each.



First Name


Last Name


Degree


Institution


Department


Address


City


State


Zip


Phone


Fax


Email


Specialty


Tuition:

$650 through March 22, 2010
$750 March 23, 2010 – April 7, 2010
$800.00 on-site registration
$350 - Allied Health Professionals
$200 - Students

The registration fee includes tuition, course syllabus, certificate of credit, and planned meal functions.

If your registration must be cancelled and your request is received in writing on or before March 8, 2010, your paid tuition, less a $50 administrative fee, will be refunded. No refunds will be granted after March 8, 2010.


Submit Registration and Proceed to Payment Page:
(Credit card and check options available)


Contact us if you have any questions.

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