HANDS-ON COMPREHENSIVE CELL INJURY/CELLDEATH IMAGING WORKSHOPS
Mail: Biomedical Diagnostics & Research, Inc., 625 S. Plumer Ave., Tucson, Arizona, 85719 or Fax: 296-8223. For more information, call 885-0662.
You may also submit this Registration Form online.
Registration Form
Name of Participant:
Title (select one):
Please Indicate 3 Workshop Dates in Order of Preference to Facilitate Scheduling:
Choice 1: 9/08-9/09 9/22-9/23 10/06-10/07 10/20-10/21 11/03-11/04 11/17-11/18 12/01-12/02 12/15-12/16 Choice 2: 9/08-9/09 9/22-9/23 10/06-10/07 10/20-10/21 11/03-11/04 11/17-11/18 12/01-12/02 12/15-12/16 Choice 3: 9/08-9/09 9/22-9/23 10/06-10/07 10/20-10/21 11/03-11/04 11/17-11/18 12/01-12/02 12/15-12/16
Department:
Institution:
Telephone #:
e-mail address:
Fax #:
Account # for billing purposes:
(Note: Receipt of payment in full required 2 weeks prior to the selected date of the workshop)
Dietary Restrictions (if any):
Reason for Taking Workshop::
(Note: this will aid in tailoring the tutorials to the needs of the 4 participants)
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