DINNER REGISTRATION

6:30 - 8:30 PM Wednesday March 26, 2008
(Room open at 6:30 for networking with function starting at 7:00)

All JIAMD Summit attendees automatically have a seat at the dinner. If you are not a JIAMD Summit registrant but wish to register, please fill out the form below.

First Name
Last Name
Company
Address
City
State
Zip Code
Phone
Email
Payment Type
Number of Tables ($280/table)
Number of Individuals ($35/person)