REGISTRATION

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Select a category
- Resident
- Clinician
First name*
Last name*
Email*
Institution*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you ?
- right handed
- left handed
Do you have a partner for dissection?
- yes
- no
Partner name
Insert the name of your partner for the dissection
VASCULAR WORKSHOP

NORTH AMERICAN ENDOSCOPIC MANAGEMENT OF VASCULAR INJURIES WORKSHOP
SEPTEMBER 9, 2019

SINUS COURSE

NORTH AMERICAN MASTERCLASS IN ENDOSCOPIC SINUS SURGERY
SEPTEMBER 10-12, 2019
- LECTURES ONLY**
  September 9, 2019
  $200,00 CAD after July 12,2019
CHOOSE YOUR COURSE OPTION
- VASCULAR WORKSHOP (SOLD OUT)
  Lectures & dissection
  September 9, 2019
- SINUS COURSE
  Lectures & dissection
  September 10-12, 2019
  $2 500,00 CAD after July 12, 2019
- SINUS COURSE
  Lectures only**
  September 10, 2019
  $750,00 CAD after July 12, 2019
Food restrictions
Payment options
- Paypal
- Wire transfer (mandatory for international registrants)***
IMPORTANT
Fees refundable less 20% before August 12, 2019. NO REFUNDS will be issued after this date.

* Field is required
** LECTURES ONLY is for SEPTEMBER 10, 2019
*** If you wish to pay via a wire transfer, instructions will be emailed to you one you have submit your registration form.
Total
$ 0.00 CAD

@ 2016 North American Masterclass