Southwest Nephrology Conference 2024 Registration

Full Name*

First NameLast Name

E-mail*

example@example.com

Phone Number*

Format: (000) 000-0000.

Primary Certification & Credentials*

Specialty*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Lunch Meal Selection*

Thursday, 3/7Friday, 3/8Both Thurs & Fri

I understand and acknowledge that in-person attendance at the Southwest Nephrology Conference may potentially expose me to contact with one or more persons with, and/or exposed to the COVID-19 virus. I understand that, as a result, my in-person attendance at this event may expose me to a risk of exposure to or infection with the COVID-19 virus. I knowingly assume this risk. I understand that vaccination with an approved COVID-19 vaccination is encouraged and that I am required to and agree to follow all required safety measures put in place by the Conference.*

I have read and understand the above acknowledgement.

Privacy Policy: In the course of operating this event and in an effort to deliver the highest quality service possible, your contact information, including name and email address may be shared with commercial supporters.*

Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.

Registration Type (Please select one only)*

Physician- 2 Day

$399.60

Physician- 1 Day

$266.40 Day Choice

Advanced Practice, Pharmacist, Nurse, Dietician, Social Worker, Technician, or Fellow in Training- 2 Day

$207.50

Advanced Practice, Pharmacist, Nurse, Dietician, Social Worker, Technician, or Fellow in Training- 1 Day

$166.25 Day Choice

Point of Care Ultrasound Immersion Course

$1,000.00

Student in Training- 2 Day

Must have a current valid student ID to show. Registration type does not provide CME/CEUs.

$82.50

Student in Training- 1 Day

Must have a current valid student ID to show. Registration type does not provide CME/CEUs

$41.25 Day Choice

Planning Committee Member

Must be part of official planning committee for SWNC 2024

$ Free Number of DaysDays Attending

Sponsorship Package Complimentary Attendee

Must be included in the sponsorship package your company has purchased and you must be designated on their list submitted for those in use.

$ Free Number of DaysDays Attending

Exhibitor for Sponsorship Booth

Must have already purchased sponsorship booth and be designated on list submitted by company.

$ Free Number of DaysDays Attending

Non-CME/Added Exhibitor Pass

Registration type does not provide CME/CEUs

$187.50 Number of DaysDays Attending

Enter coupon

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Southwest Nephrology Conference Registration