Registration
All
Cart is Empty
|
View Cart
Skip Menu
Registration Home
Registration
U-CARS Home
»
Registration
»
All
» APRN/ PA-C/ Pharmacist- (Non-affiliated)
APRN/ PA-C/ Pharmacist- (Non-affiliated)
Price:
125.00
Quantity:
Early Bird (valid thru 12/08) = $75
Advance (valid thru 02/05) = $100
On-Site (valid 02/07-02/10) = $125
First Name*
Last Name*
Preferred Name for Badge*
Credentials (HOLD Ctrl-key to select more than one credential)*
MD
DO
PhD
MPH
Resident
Fellow
Physician Assistant
Medical Student
BS
RN
BSN
Nurse Practitioner
Medical Assistant
PharmD
Perfusionist
Research Assistant
Research Coordinator
Postdoctoral Fellow/ Researcher
Professor
Assistant Professor
Associate Professor
Other
Credentials - Other
Title
Affiliation*
Email*
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Fed. Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Island
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
N. Mariana Is.
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Palau Island
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Country*
Thursday Night Dinner*
Yes
No
