PET Drug Manufacturers Summit Registration Form

PET Drug Manufacturers Summit Registration Form
Thank you for your interest in the PET Drugs Manufacturers Summit. Please complete the registration form below and submit payment to confirm your participation.

Each attendee must complete his or her own, individual registration form and payment transaction. Up to two representatives from each member entity may register to attend the Summit. A confirmation email will be sent upon successful registration and payment.

Registration includes access to all Summit sessions, related meeting materials, breakfast, lunch, and scheduled refreshment breaks.

Registration Fees

Category	Fees
Coalition Member	$350.00
Non-Member	$800.00

- Due to limited space we require no more than 2 representatives per entity.
- Each attendee must complete a separate registration form and payment transaction.
Contact Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Professional Information
Institution
Job Title
Attendance Information
Dietary Restrictions or Food Allergies
Are you a Coalition member?
The Coalition member price is $350.00.

Please select the registration category below that corresponds to your membership status. Member pricing is available only to active Coalition members.
- Due to limited space we require no more than 2 representatives per entity.
- Each attendee must complete a separate registration form and payment transaction.
Not a Coalition member but interested in becoming one?

Learn more about the benefits of membership and how to get involved in advancing PET drug manufacturing standards.

Contact us at cmetzger@petdrugmanufacturers.org or visit our membership page: www.petdrugmanufacturers.org/membership
The Coalition Non-member price is $800.00.

Please select the registration category below that corresponds to your membership status. Member pricing is available only to active Coalition members.
- Due to limited space we require no more than 2 representatives per entity.
- Each attendee must complete a separate registration form and payment transaction.

Coalition Member

Please select this option if you are an active member of the Coalition.

$350.00

Coalition Non-Member

Please select this option if you are NOT an active member of the Coalition.

$800.00

Enter coupon

Total

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Last Name

Credit Card Number

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Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

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