ON LINE REGISTRATION FORM FOR CARIBBEAN NEUROSURGERY CONFERENCE

Sheraton Hotel and Casino, San Juan, Puerto Rico- - November 8 - 11, 2017

Complete all the data fields then click on the submit button. All fields marked with an asterisk are required.

First Name *

Last Name *

Your email *

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Your Occupation - select one

Office phone ( include area code)

Cell phone (include area code)

Your postal address 1

Your postal address 2

City

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Date Form Completed

 

I wish to register for the CANS 43rd Annual Neurosurgery Conference November 8 - 11, 2017

 

I will be attending the Welcome Reception on Wednesday 8 November 2017. If "yes" state the name of your guest here

 

I will be attending the Formal Awards Banquet on Friday 10 November 2017. If "yes" state the name of your guest here

 

I wish to submit a scientific paper for consideration of inclusion in the scientific program.

 

If you wish to submit a scientific paper for consideration of inclusion in the scientific program please submit the title, the name of the presenting author, and a brief summary of less than 200 words in the larger text box below.

This box is reserved for scientific abstracts only. The final date for abstract submission is 15 October 2017.


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