Society for Neuro-Oncology Conference Registration ~ Fifth ...



Society for Neuro-Oncology

25th Annual Scientific Meeting and Education Day

November 2020 – Virtual

(please print clearly)

|Last Name |First Name |Middle Name or Initial |Degree |

|Institution |Department |

|Street Address |Gender (optional) |

|City |State or Province |Postal Zip Code |Country |

|Telephone |Fax |Email |

|Specialty: ( BS-Basic Science ( ST-Biostatistics ( EP-Epidemiology ( MO-Medical Oncology ( NO-Neuro-Oncology ( |

|NS-Neurosurgery |

|( NU-Nursing ( PA-Pathology ( PE-Pediatrics ( PS-Psychology ( RO-Radiation Oncology ( RA-Radiology ( Other |

|_______________ |

2021 SNO Membership Full Membership $485

(new or renewal) Trainee Membership $ 95 $________

2020 SNO Virtual Annual Meeting

Through 11/01/20 After 11/01/20

SNO Full Member $245 $295

Student/Trainee $145 $195

Allied Health Professionals $145 $195

Int’l Developing Region $145 $145

Non-member $795 $845

$_________

TOTAL $_________

PAYMENT

MasterCard, VISA, American Express #_______________________________________ Sec. Code _________ Exp. Date ___ / ____

Name as it appears on card ____________________________________________ Signature ________________________________

Mail Completed form to: SNO, PO Box 273296. Houston, TX 77277-3296 or fax to 713-583-1345

Questions? Contact Linda Greer, linda@soc-neuro- or 346-980-6935

-----------------------

Includes all live virtual content as well as on-demand content until November 1, 2021

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download