2018 IFSER Educator's Summit Registration
July 27th & July 28th Norfolk, Virginia
Hosted at Eastern Virginia Medical School
Attendees First Name *
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Attendees Last Name *
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Mailing Street Address *
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City, State, Zip *
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E-Mail Address *
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ARDMS #
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SDMS #
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CCI #
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Phone Number *
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Date of Birth (for CME's) *
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Will you be staying at the Sheraton Norfolk Waterside? *
Please indicate the days you plan to attend: *
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Will you be using PayPal link provided on the 2018 Educator's Summit page at www.IFSER.org? *
To assist us in tracking registrations, please indicate the name of the person or organization who will be making the payment for this attendee. (If self, please state "self") *
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