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Registration
Hotel Information
Schedule
(TBA)
Sponsors
(TBA)
Speakers
SAL Banquet
Contact
Meeting Home
www.laacs.org
Register for LAACS/SAL Joint Annual Meeting
*Full Name:
* Degree:
MD
MD FACS
* Specialty:
*Hospital or Practice Affiliation:
(as you wish it to appear on your name badge)
Address:
City / Zip:
*Phone:
-
-
x
Fax:
-
-
* Email:
*Membership Status:
--
Resident
Medical Student
MD, FACS
*Register me for the following:
Fri., Jan. 16, 2009 SAL Banquet
Sat. Jan. 17, 2009 Scientific Meeting
Sat. LA-ACS Business Lunch*
Sat. Surgical Jeopardy & Reception
Sun., Jan. 18, 2009 Scientific Meeting
Dietary Restrictions :
*Please List
Type of Membership:
Member
Resident
Medical Student
Non-Member
Registration Fees:
LA-ACS/SAL Member who paid 2008 or 2009 - no registration fee
Non-Members -$150.00
Payment:
Payment can be made by check or credit card. No refunds after Monday, January 5, 2009. Credit Card Payments:
download credit card authorization form.
Mail payment to: PO Box 23512, NOLA 70183
