This
order form is protected by Secure Socket Layer Technology
("SSL"). This is an advanced encryption technique that
ensures secure data transfer between your browser and the secure
server
Did
you receive a conference brochure? Yes
No
If yes, what is the Key Code on the label? Keycode:ex. I860F1 or F30
Conference Pricing
Commercial
Academic, Government,
Hospital-Affiliated
Conference
& Workshop (BEST VALUE!)
Advance
Registration until September
1, 2006
$1245
$620
Registration
after September
1, 2006
$1445
$695
Conference
Only
Advance
Registration until September 1, 2006
$1145
$525
Registration
after September 1, 2006
$1345
$595
Tutorial
Only
$395
$250
Poster
Discount
$50
off
$50
off
Poster Presentation
Poster abstracts for this conference are no longer being
accepted on this site.
If you wish to present a poster at this conference,
please email Christina Gregory at cgregory@healthtech.com
for details.
I
would like to receive a copy of this conference brochure by mail.
All attendees of CHI’s
events
will receive a complimentary subscription of CHI’s
Molecular Med Monthly
e-newsletter. If you do not wish to
receive a
subscription, please check this box.
Your Information
Mr.
Ms. Mrs.
Dr. Prof.
First:
Last:
Title:
Div/Dept.:
Company:
Address:
City:
State:
Zip:
Country:
Email:
Phone and fax numbers are
required to process form
Telephone
Fax:
Would you like to receive CHI event updates via fax?
Yes
No
Credit
Card information is required to process form
This
order form is protected by Secure Socket Layer Technology
("SSL"). This is an advanced encryption technique that
ensures secure data transfer between your browser and the secure
server