Event Registration

Instructions

Please complete the registration form and click Submit to attend OsteoMed’s Advanced Solutions in Foot Surgery.

Keep in mind name MUST match your government issued photo identification.

Space is limited.

Once the completed form is returned, OsteoMed’s travel agent will contact you to book your flight.

 

All fields are required unless otherwise indicated.

 

Enter registration code:

Participant Information

First Name:
Middle Name: (optional)
Last Name:
Address:
 
City:
State:
Zip Code:

 

Work email:
Work Phone:
Cell Phone:
Hospital(s) Affiliation:
NPI #:
Hospital(s) Address:
State(s) of Medical License:
License #:
Date of Birth:
Gender:    

Flight Information

Seating Preference:    
Departure Airport:
Departure Date: 3/23/12 4/27/12
Preferred Departure:    
Return Date: 3/24/12 (after 6 p.m.) 4/28/12 (after 6 p.m.)
Frequent Flyer Information: (optional)
Special Needs Request: (optional)

Instructions

Please complete the registration form and click Submit to attend OsteoMed’s Spine Distrubutors Sales Meeting.

All fields are required unless otherwise indicated.

 

Enter registration code:

Participant Information

Full Name (incl. middle initial):
Email:
Distributorship Name:
Name to appear on badge:

Arrival Information/Departure Information

Accommodations will be made at the Double Tree Hotel in Las Colinas, TX. OsteoMed will cover room and tax charges for Thursday and Friday night. Plan to arrive either Thursday, May 16th or by 11:00 am on Friday, May 17th and depart after 2:00 pm on Saturday, May 18th.

Instructions regarding flight itenerary and ground transportation will be included in your email confirmation.

HP Byron Nelson Championship Tickets

You will have tickets to the HP Byron Nelson Championship on Friday and Saturday for the meeting. Please check additional days you would like to attend:

Wednesday, May 15th:
Thursday, May 16th:
Sunday, May 19th:
Golf Shirt Size: