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CCS
Workshop |
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This form is
for CCS workshop registration only.
If you need lodging see the location
page for accommodations information.
Complete the online form and click the
submit button to send your registration
and payment. Your card will be charged
$295.00. The fee includes the academic
sessions, all course material, and coffee/tea
during breaks. Confirmation of your
registration along with an itinerary
will be sent after processing your payment.
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Choose CCS Workshop
Date |
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Note: *
Fields are mandatory |
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| Saturday, January 24, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Saturday, February 21, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Saturday, March 28, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Saturday, April 25, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Saturday, May 30, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Saturday, June 27, 2009 [New York]
9:00 am to 5:00 pm Only For $ 295 (USD) | | Tuesday, January 13, 2009 [Tennessee] 1:00 pm - 7:00 pm Only For $ 295 (USD) |
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Personal
Information |
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Title* |
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Sex* |
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Female |
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First
Name * |
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Last
Name * |
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E-Mail
* |
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Address 1 * |
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Address 2 |
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City
* |
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State
* |
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Country
* |
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Zip Code
* |
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Phone
Number * |
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**Your
subscription may be verified at this number. |
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Billing
Information
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I would like to use
the same information for billing |
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First
Name * |
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Last
Name * |
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Address
1 * |
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Address
2 |
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City
* |
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State
* |
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Country
* |
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Zip
Code * |
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Phone
Number * |
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Select Your Payment Option |
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View
Privacy & Internet Security |
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Academic
Information |
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Specialty: |
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Yr. of Residency: |
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Last USMLE Step3 Score: |
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Number
of Step3 Attempts: |
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Hospitals of Training/Details:
(1) |
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(2) |
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(3) |
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Additional
Information |
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How
did you hear about us |
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Other,
describe: |
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Additional
Questions or Comments |
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Conditions:
| Confirmation
of registration will be sent to you
by email with the details of the course
curriculum. In the event of a cancellation
of either Course by Premier Review,
the company will refund the full tuition
fee, but will not be held liable for
any other expenses. The Premier Review
reserves the right to substitute teachers
for either course. A handling fee of
$100 will be charged on all attendee
cancellations. Refunds will only be
granted to the person or company who
issued the payment. For a refund, written
notice of cancellation must be received
30 days before the course |
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By checking this box I agree
to the conditions above . |
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Click the submit button to send your registration
request. |
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