Masters in Urology
TBD 2009

Elbow Beach Resort
Bermuda

Course Registration Form

 

Registration Deadline is TBD, 2009.

Mail to:
Diversified Conference Management, Inc.
4020 Phantom Horse Place • Marana, Arizona 85658 USA
(520) 744-6076 or (800) 458-2535   
Fax: (520) 744-6092
Fax for Registrations Only: (734) 253-2679
E-mail: dcmi@comcast.net

Please print out the form below, fill out, and either mail to the above
address or fax back to the above fax number or register on-line.

Your Name Specialty Address City, State, Zip Telephone Number Fax Number E-Mail Address Please Enter name of course you are registering for Enclose a check (U.S. Currency Only) payable to DCMI for: Registration Fee: $695 before TBD $795 after TBD   If Paying by Credit Card: Credit Card Number Expiration Date Specify Either MasterCard VISA   Signature (if mailing or faxing in form)   Home | About Us | Contact Bermuda Urologic | Faculty | Agenda | Information | Hotel | Registration   Copyright ©2001. All Rights Reserved. Last Revised 10-25-08