SCAVIR

Links:

YOU MAY REGISTER FOR THIS SEMINAR ON-LINE BY FILLING OUT THE FORM BELOW AND SIMPLY CLICKING SUBMIT, OR MAILING IT TO THE ADDRESS BELOW. YOU MAY ALSO PAY FOR THIS SEMINAR ON-LINE WITH THE PROVIDED SECURE LINK OR MAIL YOUR PAYMENT TO THE ADDRESS BELOW.

REGISTRATION FORM: "THE SANCTUARY OF ENDOVASCULAR THERAPY"
Kiawah, S.C.
February. 28 - March 1, 2008

NAME

HOME ADDRESS

CITY

STATE

ZIP CODE

E-mail

HOME PHONE

WORK PHONE EXT

FAX NUMBER

Employer

Title

RENEWING MEMBERS ATTENDING THE SYMPOSIUM PLEASE INCLUDE AVIR/ARNA
MEMBERSHIP NUMBER

FOR ALL RENEWING MEMBERS ATTENDING
THE SYMPOSIUM PLEASE INCLUDE AVIR/ARNA
MEMBERSHIP NUMBER

REGISTRATION FEES

Allied Health Professional
Before Jan. 10th $150.00
After Jan 10th $225.00

Physicians
Before Jan 10th $350.00
After Jan 10th $425.00

Full Day $ 100.00
Half Day $ 50.00

INFORMATION PLEASE CALL 843-792-7456 OR FAX QUESTIONS
TO 843-792-5551 /E-MAIL scavir@comcast.net

PLEASE MAKE CHECKS PAYABLE TO SCAVIR:
ADDRESS: SCAVIR

C/O JOHN H. FURTEK

30 FITZROY DR.

CHARLESTON, SC. 29414

LIMITED SEATS AVAILABLE……..REGISTER EARLY.