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)

February 8 - 11, 2010 ($875)

Feb 8 - 12, 2010 ($1000)
(Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)

Feb 12, 2010 Anatomy ONLY ($175)

March 22 - 25, 2010 ($875)

Mar 22 - 26, 2010 ($1000)
(Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)

Mar 26, 2010 Anatomy ONLY ($175)

April 19 - 22, 2010 ($875)

Apr 19 - 23, 2010 ($1000)
(Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)

Apr 23, 2010 Anatomy ONLY ($175)

May 17 - 20, 2010 ($875)

May 17 - 21, 2010 ($1000)
(Includes 4-day MR program PLUS Friday Cross-Sectional Anatomy)

May 21, 2010 Anatomy ONLY ($175)

Name:

Address

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 530-733-3097. You may still pay using the link below

Step 3:

Go to Payment Page