MSS Virtual Spring Meeting

MSS Virtual Spring Meeting

2022 Registration Form
Name *

First Name Last Name Suffix
Choose all that apply *

MD DO FACS MBBS BA BS Other
Practice Type *

Academic Private Practice Community Hospital Employed Mixed Model
Training Program *

Hennepin County Medical Center Mayo Clinic University of Minnesota
Practice Name *
City/State

Street Address

Street Address Line 2

City State
Email *
example@example.com
Cell Phone *
Please enter a valid phone number.
Speaker *

Yes No
Registration Information
Membership Status *

Active Member Non-Member Resident Member Medical Student Research Trainee Other
Registration Fees
No Registration Fee for Active Members - a MSS membership benefit!
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Active Member 2021 MSS dues paying member
Free

Medical Students, Residents, Trainees
Free

Non-Member Join the MSS chapter | no fee to attend the spring and fall meetings
$ 175.00

Total

$ 0.00
Should be Empty:

Registration Information