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

PNEC 2019

May 24, 2019 | The Conference Center at Convention Place  | Corner of 8th Avenue & Pike Street (Entrance on Pike Street)  | Seattle, WA 98101 - PNEC (May 24, 2019) - PNEC Simulation Summit for Fellows/Resident (May 23, 2019)

Correo electrónico de confirmación perdido? Haga clic aquí para volver a enviar.

Información Personal

Nombre: *

Apellido: *

Centro Médico / Hospital / Empresa: *

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

Hospital-Based Practice Private Practice Other

title *

Título: * (seleccionar un máximo de dos designaciones)

Usted puede seleccionar un máximo de dos designaciones.

Dirección: *

Dirección 2:

Ciudad: *

ESTADO/PROVINCIA: *

Código Postal: *

Correo electrónico: *(Format: email@domain.com)

Teléfono (Día): *(Format: XXX-XXX-XXXX)

Celular: *(Format: XXX-XXX-XXXX)

País: *

Confirmar correo electrónico: *(Format: email@domain.com)

Secundaria Correo electrónico: (Format: email@domain.com)

Secundaria confirmar Correo electrónico: (Format: email@domain.com)

Confirmacion y el certificado de asistencia sera enviado al correo electronico indicado en este formulario.

Información Profesional

:*(Please select one)

    	    
Physician
    	    
Industry or Non-clinical
    	    
Nurse or Allied Health Professional
    	    
Student*
    	    
Resident (Competition-Invitation Only)
    	    
Fellow or Resident (PNEC Only)
    	    
Senior Fellow or Resident (PNEC & Simulation Summit)

Estado Licenciado (EEUU): *

Estado Licenciado 2 (EEUU):

Número de licencia medica (EEUU): What is this

Servicios Especiales (ADA) Y Restricciones en la dieta:What is this

IMPORTANT NOTE:
SENIOR FELLOWS (PNEC & SIMULATION SUMMIT):

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, May 24, 2019, 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.

Más Información

¿Cual fue la razon principal que contribuyó a su decisión de asistir a este simposio? *

¿Requiere una carta de invitacion para fines de Visa?

HAVE YOU ATTENDED PNEC IN THE PAST?

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Cuotas de Inscripción

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Cuota de inscripción:
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Additional Fee:
Código de Descuento
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