Registration Form: Annual Review
Course in Radiation Physics
for Radiology Residents: Early Bird Registration
I wish to use a Credit
Card-
I will submit my payment with secure transmission using Paypal.com. If
you do not have a paypal account, you can simply click on the check out
links to use credit cards at that site.
Early Bird Participation:
No, I will send you a check for
$600
If you are paying by check, we expect payment before July 1, 2008 to hold
your spot at this price.
Print out this page (or your confirmation page) and return in an
envelope with your check for $600.00
payable to: Consultants in Nuclear Medicine
2910 W. Estes Avenue
Chicago, IL 60645
Registration: Annual
Review in Radiation Physics for Radiology Residents
For
Additional Information: Please
Contact Stephen M. Karesh, Course Director at...
Consultants in Nuclear Medicine
2910 W. Estes Ave
Chicago, IL 60645
Phone: (773)
802-7617 FAX:(773)
304-2545
E-mail: nucmedconsultants@comcast.net
Please complete this registration form:
Name:
Address:
City:
State:
Zip Code:
Email Address
Hospital or Clinic
Work Phone
Work Fax
I learned about this course:
Flyer in Mail
A Colleague
Website
Courses Offered By This Website Are Not Affiliated With or Sponsored by
Loyola University
Medical Center.