The Management of Pleural Diseases including Medical ... - CME

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General Information Registration Information • Complete Course - $900 (USD) • Day 1 - Lectures Only: $450 (USD) Register early, space is limited to 25! All foreign payments must be made by a draft on a United States Bank or by Visa or MasterCard. If paying by check, please make payable to Harvard Medical School and mail with completed registration form to Harvard Medical School-Department of Continuing Education, P.O. Box 825, Boston, MA 02117-0825. If paying by credit card, please register online at www.cme.hms.harvard.edu/courses/pleuraldiseases. Telephone or mail-in registration with credit card payment is not accepted. Inquiries should be directed to the above address, made by phone: (617) 384-8600, Monday-Friday, 10 AM to 4 PM (EST), or by email: hms-cme@hms.harvard.edu. Upon receipt of registration a confirmation will be mailed to the address listed on the form. Refund Policy A handling fee of $60 is deducted for cancellation. Refund requests must be received by mail or fax one week prior to the course. No refunds will be made thereafter. Course Location and Accommodations Hotel rooms in Boston are limited. You are urged to make your reservations early. A limited number of rooms have been reserved at The Brookline Courtyard by Marriott (Telephone: 866-296-2296) until November 11, 2008. Please specify that you are enrolled in this course to receive a reduced room rate of $159 Single/Double per night. A limited number of rooms have also been reserved at The Hotel Commonwealth (Telephone: 617-933-5000) until November 11, 2008, offering a reduced room rate of $239 Single/Double per night. A map of Boston listing local hotels will be sent with your confirmation of enrollment. For additional housing assistance, call Boston Reservations at (617) 332-4199. Travel For information on reduced airfare, call Harvard Medical School’s Department of Continuing Education at (617) 384-8600, Monday - Friday, 10 AM to 4 PM (EST). Program changes/substitutions may be made without notice.
✄✄ REGISTRATION FORM The Management of Pleural Diseases including Medical Thoracoscopy and Other Procedures Class # 281022 Full Name__________________________________________________________________________________________________________ December 11-12, 2008 First Middle Initial Last Degree Mailing Address ______________________________________________________________________________________________________ Complete Course - Street City State Zip Code Physicians: $900 (USD) Daytime Phone (_______) ______________________________________Fax Number (_______) _____________________________________ EMail Address_____________________________________________________________________________________________________ Please check if you wish to be eexxcclluuddeedd from receiving email notices of future Harvard MED-CME programs. Professional School Attended _________________________________ Profession ____________________________Year of Graduation ______ Principal Specialty ___________________________________ Board Certified? Yes No Organization Affiliation _____________________ Complete Course - Residents*/Fellows Training* and Allied Health Professionals: $900 (USD) Check is enclosed. Please make your check payable to Harvard Medical School and mail with this registration form to: Day 1 - Lectures Only: $450 (USD) Harvard Medical School - Department of Continuing Education, PO Box 825, Boston, MA 02117-0825 Registrations paid by credit card may be made online at www.cme.hms.harvard.edu/courses/pleuraldiseases PLEAS NOTE: TELEPHONE OR MAIL-IN REGISRATION WITH CREDIT CARD PAYMENT IS NOT ACCEPTED. Yes, I will be attending the dinner on December 11th Online Registrants: Add the first three characters of the source code, found here Source Code: WEB CC FORM OF PAYMENT *A letter of verification from Department Chair must accompany registration form for a reduced fee.
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The Management of Pleural Diseases including Medical ... - CME

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