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

GEST 2020

May 14, 2020 | Sheraton New York Times Square Hotel | 811 7th Avenue, 53rd Street | New York, NY

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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 Other

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Designations: * (Select up to two degrees)

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Preferred Mailing Address 2:

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Zip: *

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

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

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

Country: *

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

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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
    	    
Fellows, Residents and Students
    	    
Nurse or Allied Health Professional
    	    
Industry or Non-clinical

US STATE OF PROFESSIONAL LICENSURE: *

US STATE OF PROFESSIONAL LICENSURE 2:

License #: What is this

SPECIAL SERVICES (ADA):What is this

*Fellows/Residents/Students may apply for the Fellows/Residents/Students Scholarship by submitting a letter from their director, on institutional letterhead, confirming the fellowship, residential or medical student status, along with the application found online at www.embolization.com. Both letter and application must be submitted together to mlescanofeher@ccmcme.com.

More Information

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DO YOU REQUIRE A LETTER OF INVITATION FOR VISA PURPOSES?

HAVE YOU ATTENDED GEST IN THE PAST?

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Registration Fees

Fee Description TOTAL
Registration Fee:
None
Optional Session Fee:
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