ONLINE REGISTRATION FORM

Welcome to the registration web site for Emerging Therapies for Relapsed and Refractory Lymphoid Neoplasms. To reserve your place for this activity, please complete the following information.

Friday, June 6, 2008
Palazzo dei Congressi, Convention Centre
Room A
Lugano, Switzerland
18:00–20:30

You will receive an electronic CONFIRMATION of your registration within 48 hours of receipt.

*These fields are required in order to complete your registration.

First Name: Last Name:  
 
Degree: Title/Position:
Specialty:
Affiliation:
Address:Home  Business
City: State: Zip Code:

Country: Telephone:
Business  Home

Email Fax
Special physical, dietary or other needs/requests:

(ADA accommodations will be made in accordance with the law. If you require ADA accommodations, please indicate your needs at the time of registration in the box provided above.)

What questions regarding the treatment of relapsed and refractory lymphoid neoplasms would you like the faculty to address?
1.
2.
3.

For more information regarding this educational activity please click here.

(Note: you must have Adobe Acrobat Reader to view these files. Please go to www.adobe.com to download for free.)

If you have any trouble with this registration site, please contact the Institute for Continuing Healthcare education at meetings_registration@iche.edu
or 1-866-242-8084, ext. 1501.