PRSH Exhibit Registration Form-Credit Card

Puerto Rico Society for Histotechnology
XVI Histotechnology Symposium
Exhibitor Registration Form
January 30, 2027
Fed. Tax ID: 66-0671870

Company Name:

Address:

Address 1

Address 2

CityState/Province

Zipcode

Contact Person:

Phone Number

Area CodePhone Number

Fax Number

Area CodePhone Number

Email Address

example@example.com

Representatives Attending the Meeting

Exhibit Registration/Sponsorship

Contact Phone Number for Lead Representative Attending

Area CodePhone Number

Display Type:

Please indicate type of display. (All displays that rise above the table top will be placed up against the outside wall as not to block other exhibitors.)

Send check payable to:

Puerto Rico Society for Histotechnology

Mail to:

PRSH
Calle Cisne # 489
Camino del Sur
Ponce, PR 00716

Exhibit Registration/Sponsorship*

Credit Card Information:

Exhibit Registration/Sponsorship