Online Conference Registration

Introductory Workshops for Ultrasound Guided Nerve Blocks (IUWB08)

Welcome to the online registration page for the UHN Introductory Workshops for Ultrasound Guided Nerve Blocks (Conference ID - IUWB08). Please follow these steps to complete your registration.

1.	Fill in your Personal Information (Step One) and click the "submit" button when completed to take you to your "Registration Confirmation" page
2.	From your "Registration Confirmation" page please follow the link to proceed to the "Payment Information" page.
3.	Complete all Payment Information fields (Step Two)
4.	Click the "submit" button at the bottom of this page. For your payment to be procesed

Please Note: your registration will not be considered complete until you provide your payment information.

Need help completing this form? Please contact
Christine Drane at 416-603-5118 or christine.drane@uhn.on.ca

Step One - Your Information
ALL FIELDS WITH * MUST BE COMPLETED

Your name:
	Title (Occupation)*

	First*
	Last*
Your Contact Information:
	Organization/Co. Name*
	Mailing Address*	Email Address*

		Telephone*	Ext

		Fax

Special Meal Requirements?*

Choose Your Workshop Date Please indicate your preference below. Click here to view complete details for this workshop. PLEASE NOTE - THE COST FOR THIS WORKSHOP IS $650 CDN.
Workshops - Available Dates for 2011

	Oct. 21-23, 2011

Workshop Information - Contact Christine Drane at: 416-603-5118 or christine.drane@uhn.on.ca
Please ensure that you have completed all fields before clicking the submit button