Spring Dermatology Review 1998: Registration

Annual Spring Dermatology Review 1998 for Family Physicians

March 14 & 15, 1998



REGISTRATION APPLICATION: ME7754



TUITION: Before After

Feb. 13/98 Feb. 13/98 On-site

Physicians $349 $374 $394

UBC Faculty $214 $229 $244

UBC Residents $79 $79 $79

(Includes refreshments, two lunches & course materials)
To ensure course materials are ready for you at the course, your registration must be received by 4:00 p.m., March 5, 1998. Registrations not received by this point will be charged the on-site rate.



NOTE: Payment must accompany registration form in order to be processed.

Name:

Mailing Address:

City:

Prov/State:

Postal/Zip Code:

Daytime Telephone:

Fax Number:


Affiliation:



METHOD OF PAYMENT:
Charge by Phone/Fax/Email
Local/Outside BC: 604-822-2626;
Toll free within BC: 1-800-663-0348;
Register by Fax: 604-822-4835;
Register by Email: reg@cehs.ubc.ca (If registering by email, please remember to include all information requested on this form including concurrent session choices)



  Card No.   Exp. Date Visa MC

  Name of Cardholder



Payment by Cheque
Please make your cheque payable to the University of British
Columbia and forward to the following address:
Registration, Continuing Education in the Health Sciences
The University of British Columbia
Room 105 - 2194 Health Sciences Mall
Vancouver, BC, Canada V6T 1Z3



Return to Spring 98, CME, or DermWeb

TUITION:	Before	After
	Feb. 13/98	Feb. 13/98	On-site
Physicians	$349	$374	$394
UBC Faculty	$214	$229	$244
UBC Residents	$79	$79	$79

	NOTE: Payment must accompany registration form in order to be processed.
	Name:
	Mailing Address:
	City:
	Prov/State:
	Postal/Zip Code:
	Daytime Telephone:
	Fax Number:
	Affiliation: