Registration Form - Mississippi Gastroenterology Society

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Mississippi Gastroenterology Society. REGISTRATION. Saturday, February 8, 2014. Hilton. 1001 East County Line Road. Jackson, MS 39211.
Mississippi Gastroenterology Society REGISTRATION Saturday, February 8, 2014 Hilton 1001 East County Line Road Jackson, MS 39211

Event Registration: Name Professional Initials (please circle one) MD DO Other Practice Name Preferred address City

State

Daytime Telephone

Fax

Zip

Email Address

Events: (Please check all that you plan to attend) Welcome Reception and Resident/Fellows Forum – Friday, February 7, 2014 CME Sessions – Saturday, February 8, 2014 Lunch and MS GI Society Business Meeting – Saturday, February 8, 2014

Registration Fee: $50 Note: this event is open to all physicians, nurses, and staff Payment Options: Check: Make payable to Mississippi Gastroenterology Society. Send form and payment to: Mississippi Gastroenterology Society Attn: Jenny White PO Box 2548 Ridgeland, MS 39158 Credit Card: Pay online by visiting: http://msgisociety.org/Events.php

Questions: Contact Jenny White at [email protected] or 601-853-6733 x 332.