Registration Form
42nd Annual Review and Recent Practical Advances in Pathology
The W Hotel Miami Beach

January 21-26, 2018

Last Name: First Name: Middle Initial:
Specialty: Degree:
Social Security # (last 4 digits only) for CME Purposes:     
If you are a foreign participant and do not have a Social Security #, please enter 1111.
Type of Practice:
Preferred Mailing Address:

If using institutional address, please include department (if applicable) and institutional name
Department:
Institution:
Street:
City: State: Zip Code:
Country:
Phone: Fax:
Email:
Registration Fees

Early Registration: On or before 10/1/2017
Regular Registration: After 10/1/2017

Registration fees are listed below.
Early Registration Fee
Regular Registration Fee
On Site Registration Fee
1.Practicing Physicians
2.Physicians in Active Duty Armed Forces, UM/JMH Alumni
3.Retired Physicians, Residents, Fellows, Pathology Assistants, and Laboratory Technologists






Registration includes participation in all general session lectures and workshops, educational materials, daily breakfast and break, and social events.


CANCELLATION POLICY: Refunds (less $75 cancellation fee) will be made ONLY if written notice of cancellation is received prior to January 02, 2018. After this date, NO REFUNDS WILL BE ISSUED.In cases where a course is cancelled due to insufficient registrations, a full tuition refund will be made. Refunds will be processed after completion of the conference.

For questions please feel free to contact Practical Advances in Pathology