Symposium Registration 2008
25th Annual SGNO Symposium RegistrationFull Circle
Name ___________________________________________________ Credentials _______________________ Address ___________________________________________________________________________________ Home Phone _____________________ Work Phone _____________________ Fax ____________________ Email Address ______________________________________ PLEASE CHECK THE APPROPRIATE BOXES BELOW: $ __________ Pre-Symposium (postmarked before February 15, 2008)
Member $100.00 Full-Time Student / Retired RN $45.00
Non-member $125.00 Full-Time Student / Retired RN $75.00 $ __________ Pre-Symposium (postmarked after February 15, 2008)
Member $150.00 Full-Time Student / Retired RN $80.00
Non-member $175.00 Full-Time Student / Retired RN $100.00 $ __________ Main Symposium (postmarked before February 15, 2008)
Member $325.00 Full Time Student / Retired RN $150.00
Non-member $425.00 Full-Time Student / Retired RN $225.00 $ __________ Main Symposium (postmarked after February 15, 2008)
Member $375.00 Full-Time Student / Retired RN $175.00
Non-member $475.00 Full-Time Student / Retired RN $250.00 $ __________ Daily Registration$125.00 per day _____ I will attend the Wednesday evening hospitality reception (no cost) _____ I will attend the Membership luncheon meeting on Thursday (must sign up now if attending) _____ I will need vegetarian options at meals MEMBERSHIP INFORMATION _____ I am a current member of SGNO $ _____________ I wish to renew my membership in SGNO $45.00 per year or 85.00 for two years $ _____________ I wish to join SGNO and take advantage of membership attendance rate: submit SGNO Membership Application (83K PDF) $ _____________ Total (U.S. Funds only) New member/First time attendee: would you like to partner with an experienced member?___ yes ___ no Experienced members, would you be willing to partner with a new member/first time attendee? ___ yes ___no Mail form with payment (US funds only) to:
Lynn Cloutier
4722 Cornoustie
Pasadena, TX 77505
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