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Dynamic Forecasting in the Oncology Environment - Kantar Health

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REGISTRATION FORM<br />

<strong>Dynamic</strong> <strong>Forecast<strong>in</strong>g</strong> <strong>in</strong> <strong>the</strong> <strong>Oncology</strong> <strong>Environment</strong> Workshop<br />

September 19, 2013<br />

Philadelphia, PA<br />

Name<br />

Title<br />

Company<br />

Address<br />

City/State/Country<br />

Zip Code<br />

Telephone<br />

Fax<br />

E-mail (required)<br />

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How did you learn<br />

about workshop? Email Direct Mail Colleague Advertisement<br />

Registration<br />

Fee<br />

Payment<br />

Method<br />

$700 USD<br />

American Express MasterCard VISA<br />

Credit Card #:<br />

Expiration Date:<br />

Pr<strong>in</strong>t Name<br />

(as shown on card)<br />

Signature<br />

______________________________________________________________________________________<br />

________________<br />

Amount<br />

Authorized<br />

_____________________________________________________<br />

______________________________________________________________________________________<br />

______________________________________________________________________________________<br />

Email L<strong>in</strong>da Morgan or fax <strong>the</strong> completed form to +1.816.285.1660.<br />

Workshop Fee: US $700<br />

Includes course, handbook, cont<strong>in</strong>ental breakfast, lunch and refreshments.<br />

<strong>Kantar</strong> <strong>Health</strong> does not provide refunds for cancellations. The registration fee may be applied to a future <strong>Kantar</strong> <strong>Health</strong> Sem<strong>in</strong>ar for you or ano<strong>the</strong>r member of your<br />

organization. Your notice of cancellation must be received <strong>in</strong> writ<strong>in</strong>g (by letter, fax, or email). No credits will be issued for those who do not attend <strong>the</strong> scheduled course<br />

and/or cancel less than two work<strong>in</strong>g days before <strong>the</strong> start of <strong>the</strong> sem<strong>in</strong>ar. In <strong>the</strong> event of a sem<strong>in</strong>ar cancellation, <strong>Kantar</strong> <strong>Health</strong> assumes no liability for non-refundable<br />

transportation costs, hotel accommodations, or additional costs <strong>in</strong>curred by registrants. This event is offered to our pharmaceutical clients and colleagues. We reserve <strong>the</strong><br />

right to exclude <strong>in</strong>dividuals who we validate as be<strong>in</strong>g competitors.

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