REGISTRATION -
12TH ANNUAL MEETING - CLINICAL APPLICATIONS OF CYTOMETRY
LAST NAME ____________________________ FIRST NAME ___________________________
INSTITUTION ___________________________ ADDRESS ______________________________
ADDRESS ___________________________ CITY _______________
STATE ____ ZIP ________
PHONE ___________________ FAX __________________ EMAIL
________________________
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FEES
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BEFORE
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AFTER
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(7-15-97)
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(7-15-97)
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MAKE CHECKS PAYABLE
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CCS MEMBER
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$375.00
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$425.00
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IN U.S. DOLLARS TO:
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*CCS MEMBER REG & 98 DUES/JOURNAL
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$425.00
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$475.00
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NON MEMBER
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$500.00
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$550.00
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CLINICAL APPLICATIONS
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STUDENT
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$225.00
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$275.00
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OF CYTOMETRY
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EXHIBITOR
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$225.00
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$275.00
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LUNCHEON WORKSHOPS (each) _____
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$ 40.00
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$ 50.00
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TOTAL ENCLOSED __________
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* 98 Dues and Journal subscription
alone $75.00
Payment Information: _____VISA _____MASTER CARD _____Check/Money
Order
CREDIT CARD # _______________________________EXPIRATION
DATE _________
(Please fill out your address on the form below and apply
postage.)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
CAC
P.O. BOX 39778
CHARLESTON, SC 29407
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Attention: Registration has been received on _________
for ___CAC, ___Cytometry Course, ___Workshops.
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