Biostatistics Workshops and Events 2013

Longitudinal Data Analysis in Practice (SORA-TABA workshop)

Health Science Building, Room 106

June 22, 2011

REGISTRATION FORM

Click here for a paper version.

Name and Billing Address

Name and Address

Please enter your name and address as they are shown on your credit card billing statement, if you are paying via credit card. Otherwise use your regular mailing address.

* Prefix:

* First Name:

* Last Name:

Institution:

* Address 1:

Address 2:

* City:

* Province:

* Postal Code:

* Country:

Email and Telephone

We will send your payment receipt to your email address. We may call you if we have any questions about your registration.

* Email: We will never sell or disclose your email address to anyone.

* Re-enter Email: Must match the email address you just entered above.

* Telephone: Please include your area code as well.

Registration Fee

Please select your registration fee from the list, if applicable.

If you select the Student Fee you MUST enter your student number and bring your student card to the workshop.

SORA and/or TABA Member Fee ($110.00) Non Member Fee ($125.00) Student Fee ($60.00) * Student #

Payment Method

Payment

Please have your credit card ready if paying via credit card online.

Mailed Cheque Faxed or Mailed Credit Card Credit Card Online

Cancellation Policy Please Note: All sales are final. No refunds or exchanges.

Finalize Registration

After you have verified all of the information on this form, please click the Finalize Your Registration button.

Last Update 4/25/2012