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  • Information Table Request Form (Nwus2009)

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    INFORMATION TABLE REQUEST FORM Northwest Urological Society 56th ANNUAL MEETING December 4-5, 2009 The Hyatt Regency 900 Bellevue way NE bellevue, WA 98004 (425) 462-1234 6' x 18" Information table only @ $1000 each (not an exhibit booth. Located outside the exhibit hall and does not include registration for company representative)

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    Information Table Request Form (Nwus2009)(2)

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    INFORMATION TABLE REQUEST FORM Northwest Urological Society 56th ANNUAL MEETING December 4-5, 2009 The Hyatt Regency 900 Bellevue way NE bellevue, WA 98004 (425) 462-1234 6' x 18" Information table only @ $1000 each (not an exhibit booth. Located outside the exhibit hall and does not include registration for company representative)

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    16 vues1 page

    Information Table Request Form (Nwus2009)

    Transféré par

    wethree
    INFORMATION TABLE REQUEST FORM Northwest Urological Society 56th ANNUAL MEETING December 4-5, 2009 The Hyatt Regency 900 Bellevue way NE bellevue, WA 98004 (425) 462-1234 6' x 18" Information table only @ $1000 each (not an exhibit booth. Located outside the exhibit hall and does not include registration for company representative)

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 1

    INFORMATION TABLE REQUEST FORM

    Northwest Urological Society 56th ANNUAL MEETING


    December 4-5, 2009

    The Hyatt Regency


    900 Bellevue Way NE
    Bellevue, WA 98004
    (425) 462-1234

    _____ 6’ x 18” Information table only @ $1000 each

    (Not an exhibit booth.


    Located outside the exhibit hall and does not include registration for company representative)

    NAME of PERSON REQUESTING TABLE:_____________________________________ _______________

    COMPANY:_______________________________________________________________________

    ADDRESS:________________________________________________________________________

    CITY:___________________________________________ STATE:_____ ZIP: ________________

    TELEPHONE:___________________________________ FAX:_____________________________

    EMAIL: __________________________________________________________________________

    $________________ Check made payable to the NWUS (U.S. Funds Only)


    (Space will only be reserved upon receipt of payment)

    SPECIAL REQUESTS:_____________________________________________________________________

    _______________________________________________________________________________________

    _______________________________________________________________________________________

    NOTE: Credit card payments are welcome.

    RETURN THIS FORM TO: Northwest Urological Society Tax ID# 91-6071545
    914 164th St. SE, Suite B-12 #145
    (866) 800-3118 office Mill Creek, WA 98012
    (360) 668-4053 fax www.nwurologicalsociety.org

    CREDIT CARD #______________________________________________________EXP DATE___________

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