MR Registration Form
After completing and submitting this form, click on the "Go to Payment Page" link to complete the registration process. Registration cannot be confirmed unless a corresponding payment notice is received.
Step 1:
Class Date (be sure and check just one)
August 11 - 15, 2014 ($1000) (Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)
August 15 2014 Anatomy ONLY ($175)
September 15 - 18, 2014 ($875)
October 13 - 16, 2014 ($875)
October 13 - 17 2014 ($1000) (Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)
October 17, 2014 Anatomy ONLY ($175)
November 10 - 13, 2014 ($875)
Name:
Address
City State
Zip
Country
Work Phone
Fax
Home Phone
Mobile (optional)
Email
Step 2: Submit registration form
Be sure and select the "submit" button before going on the the Payment Page
Note: If you experience problems with the "Submit" function, fill out this form, print it and fax it to 615-290-5229 You may still pay using the link below
Step 3:
Go to Payment Page