Abdominal Wall Reconstruction Summit

February 16 - 18, 2018

Registration Form

Space is limited, early registration is highly encouraged
Required fields (*)

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Mailing Address 2
(e.g. NJ) (e.g. 645-012-0000) (e.g. 645-012-0000)

For confirmation and communication purposes

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Registration *

MD/DO — $725
Resident/Student — $350
Corporate — $1,100

Registration Fee $

Registration is limited and will be handled on a first-come, first-served basis. Telephone registration and/or cancellations cannot be accepted.
Cancellation policy: You will receive a 50% refund of your registration fee, if we are notified by December 31, 2017.
After December 31, 2017, no refund will be made.

Your registration is not final until payment is complete. Please proceed to checkout. Please note we only accept American Express, MasterCard, Visa or Discover.

Columbia University Medical Center
Department of Surgery, CME Office

400 Kelby Street, Floor 9, Fort Lee, NJ 07024
Phone: 212.304.7813
Fax: 917.591.8734
Email: at3004@cumc.columbia.edu
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