Complete Conference Management, a division of UMA Education, Inc.

PNEC 2018

June 15, 2018 | The Conference Center at Convention Place  | Corner of 8th Avenue & Pike Street (Entrance on Pike Street)  | Seattle, WA 98101 - PNEC (June 15, 2018) - PNEC Simulation Summit for Fellows/Resident (June 14, 2018)

Lost confirmation email? Click here to resend.

Personal Details

First Name: *

Last Name: *

Medical Center/Hospital/Institution: *

Are you employed by a hospital-based or a private practice?:*(Please select one)

Hospital-Based Practice Private Practice

title *

Designations: * (Select up to two degrees)

Hold the Ctrl key while selecting additional degree.

Preferred Mailing Address 1: *

Preferred Mailing Address 2:

City: *

State: *

Zip: *

Primary Email: *(Format: email@domain.com)

Telephone (Day): *(Format: XXX-XXX-XXXX)

Mobile Phone: *(Format: XXX-XXX-XXXX)

Country: *

Confirm Primary Email: *(Format: email@domain.com)

Secondary Email: (Format: email@domain.com)

Confirm Secondary Email: (Format: email@domain.com)

CONFIRMATION INFORMATION WILL BE SENT TO YOUR PRIMARY AND SECONDARY EMAIL ADDRESSES.
CERTIFICATE INFORMATION WILL BE SENT TO YOUR PRIMARY EMAIL.

Professional Information

Select a Profession:*(Please select one)

    	    
Physician
    	    
Resident (Competition/Invitation Only)
    	    
Fellow/Resident (PNEC Only)
    	    
Nurse or Allied Health Professional
    	    
Student
    	    
Industry/Non-clinical

US STATE OF PROFESSIONAL LICENSURE: *

US STATE OF PROFESSIONAL LICENSURE 2:

License #:What is this

SPECIAL SERVICES (ADA):What is this

IMPORTANT NOTE:
SENIOR FELLOWS (PNEC & SIMULATION SUMMIT):
SIMULATION SUMMIT IS NOW FULL.
Only Senior Fellows in Cardiothoracic, Peripheral Intervention or Vascular specialties may register to attend both the Simulation Summit and PNEC at no charge and with the opportunity for travel reimbursement.
FELLOWS & RESIDENTS (PNEC ONLY):
Fellows and Residents are welcome to attend PNEC on Friday, June 15, 2018, at a discounted registration rate. Simulation Summit is NOT included.
RESIDENTS (COMPETITION ONLY BY INVITATION):
Only residents from invited institutions may register for PNEC using this category. Simulation Summit is NOT included.

More Information

WHAT CONTRIBUTED MOST TO YOUR decision TO REGISTER? *

DO YOU REQUIRE A LETTER OF INVITATION FOR VISA PURPOSES?

HAVE YOU ATTENDED PNEC IN THE PAST?

Yes No

Age Group *

Discount Code

Registration Fees

Fee Description TOTAL
Registration Fee:
None
Additional Fee:
Discount Code
Total Due: