ASCBS Course Information Registration form at bottom of this page
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Click here for Registration Form printout Registration Form for the Annual ASCBS Meeting Please complete, detach, and return with your Registration Fee
to: E-mail: [email protected] PLEASE PRINT CLEARLY NAME ________________________________________ ADDRESS _____________________________________ WEBSITE ______________________________________ SPECIALTY_____________________________________ Workshop Fees: ____ $950.00 Non-ASCBS Members(*Special $100 Membership) ____ $550.00 ASCBS Members (with paid Dues $300) ____ $525.00 Training Fellows/Residents with Letter of Proof ____ $100.00 Anatomy Demonstration (Limited to the first 40 Registants) ____ $350.00 Spouse or Guest *A Cancellation fee of $100.00 will be assessed if cancelled after April 1st 2018 **$100.00 must be added to all registration fees if paid after April 1st 2018 Credit Card # (Visa or Mastercard only) _____________________________________________ Expiration Date _________________________________________________________________ Total Amount Enclosed ___________________________________________________________
Thank you and we look forward to seeing you! Sincerely, Maria Garcia & Jessica Sanchez ASCBS Secretary
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Click here for Registration Form printout For a quick reference, the cost for exhibiting on one table-top is $550, with a $350 fee for each additional table-top required. A maximum of 2 exhibitors per table. We very much look forward to the privilege of having you participate in this annual event.
Registration Form for Exhibitors: Please complete, detach, and return with your Registration Fee to: A.S.C.B.S.: Friday, April 27th to Monday, April 30th 2018 E-mail: [email protected]
COMPANY NAME: ______________________________ Representative’s Name: ______________________________ (Dates Attending Workshop) Friday April 27th ____ Saturday April 28th____ Sunday April 29th_____ ADDRESS: ______________________________ ______________________________ ______________________________ ______________________________ PHONE: ______________________________ FAX: _____________________________ E-mail and website ______________________________________________ SUPPLIER OF: ______________________________________________ WORKSHOP FEES: 1 TABLE = $550.00 ________________ Additional tables at $350.00 each _________________ Electrical Service: $100 TOTAL AMOUNT ENCLOSED: ________________________ METHOD OF PAYMENT: ____________________________________________________________ Credit Card # (Visa or Mastercard only) _____________________________________________ Expiration Date ________________________ Total Amount Enclosed _____________________________ Signature (if by mail or fax, not necessary if by email) (If Credit Card, please include number, expiration date, and signature)
Thank you and we look forward to seeing you! Sincerely, Jessica Garcia & Maria Garcia ASCBS Secretaries |
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The American Society of Cosmetic Breast Surgery 2018 Last modified: September 18, 2021 |