Pathology Education Seminar - Registration Form

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Attendee Information:
Name: (required):
E-mail address (required):
Mailing Address:
	Business	Residence

City, State, Zip	,
Telephone:
Fax:
Please Select:	Standard Registration: $775 until Jan. 28, 2009 $825 after Jan. 28, 2009 Residents/Retired Pathologists: $600 until Jan. 28, 2009 $650 after Jan. 28, 2009

Payment Information:	Note: If paying by check, please skip this section, print this page and mail to the address below .
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Expiration Date: (mm/yy)		Security Code:
Billing Address: (If different than above)
Special Requests/Comments:
Brochure Code		(code is above your name on the mail panel)
Make checks payable to Pathology Education or PEI. Pathology Education c/o Educational Symposia 5620 West Sligh Avenue Tampa, FL 33634-4490 For more registration information, lodging, and optional activities contact Pathology Education c/o Educational Symposia: ph: 800-338-5901 fax: 800-344-0668 email: click here to email Pathology Education Travel Arrangements: Meeting is held at Snowmass Conference Center. Limited availability of nearby rooms and condominiums at discount rates for attendees, available until Dec 26th, 2008. Contact Professional Travel for discounted lodging and discounted lift tickets. 5620 West Sligh Avenue Tampa, FL 33634-4490 ph: 800-237-7230 fax: 813-806-1051 Email Cancellation and Refund: Cancellations must be received in writing. A $50 processing fee will be applied to all cancellations. Refunds requested in writing prior to January 16, 2009 will be issued for the amount of the tuition paid less the $50 processing fee. No refunds will be made on or after that date.

30th Annual Pathology Seminar