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Spring Pain Research Conference
April 26 - May 3, 2008
Marriott Grand Cayman Beach Resort, British West Indies
Meeting Registration Form
Name of Participant:___________________________________________
Institution:____________________________________________________
E-mail (please print clearly):_____________________________________
Telephone number during business hours:__________________________
When you fax this form, please send e-mail message (“I am registering for the Spring Pain Research Conference”) to rcp.az@cox.net You will receive an e-mail acknowledgment and receipt for your records.
Registration fee: (refundable less US$100 until March 10, 2008)
( ) academic: US $ 500 ( ) industry US$ 800 ( ) US$ 150 predoctoral
Credit card: Visa or Mastercard (no other cards accepted) Will appear as a charge to RCP, LLC on your credit card statement
Card Number: (please print clearly)________________________________
expiration date: __________________
Name on Card:________________________________________________
Billing address with zip code:_____________________________________ Fax this form to: eFAX: (520) 989-6051 Checks (drawn on a US Bank), made payable to: Research Conference Planners, (Federal ID# 86-0881838) may be mailed to: Spring Pain Research Conference, Research Conference Planners, 45 Valle Place, Tucson, Arizona 85737
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