ON LINE REGISTRATION FORM FOR CARIBBEAN NEUROSURGERY CONFERENCE

Hotel Dreams Bayahibe, Dominican Republic- - August 24 - 27, 2016

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 42nd Annual Neurosurgery Conference August 24-27, 2015

 

I will be attending the Welcome Reception on Wednesday 24 August 2016. If "yes" state the name of your guest here

 

I will be attending the Formal Awards Banquet on Friday 26 August 2016. 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 August 2016.


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