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Course Registration
Please complete the information below to register.
Western Section AUA
Hands-On Ultrasound Workshop
Saturday, October 27, 2018 / 2PM - 5PM
Grand Wailea Hotel, Maui
Held in conjunction with WSAUA Annual Meeting. Separate registration is required.
Limited space of 20 registrants, first come – first serve.
Fee: $350
Please select your category:
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AUA Physician
Non-AUA Physician
Resident/Fellow/Med Student
Allied Health Professional
First Name
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Middle
Last Name
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Addendum (i.e., MD, FACS)
Organization / Company
Address 1
*
City
*
State/Province/Region
*
Zip/Postal Code
*
Country
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Email Address:
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🛈
Optional 2nd Email Address:
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Office/Home Phone
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Mobile Phone (for on-site use)
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For Office Use Only
General Comments:
Cancellation Policy:
You may cancel your registration on or before October 1, 2018 without penalty. You will receive a full refund promptly. Cancellations
for any reason
received after October 1, 2018 cannot be refunded unless your spot is resold. Registration is transferable to a friend or associate. No shows cannot be refunded.
NEED HELP:
Please call or email us at 714-550-9155 (
info@wsaua.org
) for assistance. Thank you.