9th Annual Orthopedic Winter Meeting
Program Registration Form

Back to winter Meeting

To pay by check, please print the form and mail to: NHMI, 35 Kosciuszko Street, Manchester, NH 03101 or Fax to 603-627-0880. Early Bird (by December 1): $600.  After December 1: $675.  Event dates: January 23-24, 2009. Note: Confirmed registrants will receive notification by mail or fax within two weeks of registering. If you do not receive a confirmation notice, please contact us at 603-627-9728.

Please provide the following course registration information.

Name Credentials
Guest Name Credentials


Other:
Clinic Name

Clinical Address
(If different than address used to pay via credit card)

 
City State
Zip Phone
Fax Email*
Room Preference
(Please contact NHMI directly to explore room upgrade options)
Optional Workshop Friday January 23rd: 

No, I am not attending the workshop


Registration fee includes one regular room at the Stoweflake Mountain Resort and Spa. Other accommodations may be available for an additional fee. Please contact NHMI for more information.

*Required. Email address must match the one used on the credit card transaction.

 

 

 

 

 

 

 

 

 
 

 

 
 
New Hampshire Musculoskeletal Institute
35 Kosciuszko Street | Manchester | NH | 03101
Phone: 603-627-9728 | Email: info@nhmi.net
  
     
 
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