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2007 Annual Fall Meeting - Online Registration Form
ANNOUNCEMENT  |  (online) REGISTRATION FORM  |  (printable)  REGISTRATION FORM  |   FALL FORUM   |   STUDENT HOSPITALITY SUITE

2007 ANDP Annual Fall Meeting
November 3, 1007
5:30 p.m. until 7:30 p.m.
San Diego Marriott Hotel and Marina
Manchester 1 and 2
San Diego, CA

Online Registration Form

Name
            (Title, First, Middle Initial, Last, Degree)
Department or Program Represented 
University or Institution 
Address 
City      State      Zip
Phone   FAX   E-mail

REGISTRATION FEES

               Registration Fee
                            

 $ 
              Guests @ $30.00 each $ 
          Guest Name(s) 
         
         
         
Total:  $ 
PAYMENT OPTIONS
          Check         


          Credit Card  

 Make check payable to  ANDP or Association of Neuroscience Departments and Programs.  US currency only. Drawn on US Bank.   Purchase Orders are not accepted as payment.  Mail to address below.
CREDIT CARD INFORMATION

          Card Type
                    Discover
                    American Express
                    Visa
                    MasterCard 
          Card Number        Expiration Date  
          Name on Card
          Authorized Signature (if mailed) 

          Billing Address
                     Street 
                     City    State     Zip 
                     Cardholder's Phone 


 DEADLINE FOR RECEIPT OF REGISTRATION AND PAYMENT: October 19, 2007
Association of Neuroscience Departments and Programs (ANDP)
41218 Roundup Road
Magnolia, Texas 77354
(281) 259-6737 (PHONE)    (281) 356-2837 (FAX) 

 

Last Modified:  September 19, 2007
http://www.andp.org/meetings/2007/fall.htm