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Mailing Address:
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Date of Birth:
(required for tracking
CME credits/CEU) |
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Any special needs? (sight impaired, wheelchair, etc.)
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Check all that apply:
Participant - $325
Nurse - $225
Spouse/guest (for all social events) - $200
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Attending social event?
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Please indicate your background:
Neurosurgeon
Radiation Oncologist
Medical Physicist
Other (please indicate)
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| Lodging not included. Participants will have a choice of three hotels: Boars Head Inn, Marriot Courtyard, and Sponsors Resident Center at the Darden School of Business -- see brochure attached for details. |
Payment by:
Mailing check
Department check to follow
Visa
Master Card
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Symposium Chair:
Ladislau Steiner MD, PhD
Professor of Neurological Surgery and Radiology
If mailing check, please send payment to:
Sophie Lee Yu
Conference Director
UVA Dept. of Neurosurgery
PO Box 800212
Charlottesville, VA 22908 USA
Phone 434-924-2336
Fax 434-977-6279
Email: sly9p@virginia.edu
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