How did you learn about the seminar? ____Brochure
____E-mail ____Personal Contact ____
Website
______ Field
Traumatology, August 21-22, 2008 (15 CEUs)
Registration: 7:45 a.m. Seminar: 8:00 a.m. - 5:00 p.m.
(Lunch on your own)
Cost: $225. Course fee is discounted to $195
($125 for students) if registration is received on or by August 8.
Refund and Cancellation Policy:
Registrations cancelled by August 8 are subject to an
administrative fee of $35. No refund will be granted after August 8
but participants may apply the fee to a future seminar.
Payment method: ______ check
______ credit card (Payable in US dollars)
Charge to: _____ MasterCard
_____ Visa Amount: $___________
Card # ________________________________ Expiration date:
_______/_______
Name on
card:_______________________________________________________
Cardholder
signature:_________________________________________________
Fax with
credit card information to 405-691-0452 or mail
form
with check made payable to:
Oklahoma Traumatology Institute
3037 N.W.
63rd St., Suite 150
Oklahoma
City, OK 73116
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