Lewis and Clark Meeting | Pre-Registration Form


LEWIS AND CLARK VETERINARY MEETING

SPONSORED BY: INTERSTATE VETERINARY MEDICAL ASSOCIATION

Marina Inn South Sioux City, NE

Pre-Registration ends September 1, 2016


How Many?

Event

Pre-Registration Cost

At-Door Cost

Sub-Total

 
Complete Meeting $225

$225

$225
Small Animal Session
(Wednesday Only)
$150

$150

$150
Small Animal (Only) $200

$200

$200
Large Animal (Only) $200

$200

$200
Technician Complete $75

$75

$75
Technician
(Wednesday only)
$35

$35

$35
2016 Vet Graduates $110

$110

$110
*Printed Info Booklet (or choose below) $20

$20

$20
*Pre-loaded Info USB Drive (no cost) $0

$0

$0


Email *
 
Clinic Name *
 
Full Name *
 
Address *
 
City, State Zip *
 
Spouse's Name
 
Doctor's Names - separate by commas
 
Technician's Names - separate by commas
 
I will be paying by PayPal
 
I will be sending a check to
709 11th Street SE Orange City, IA 51041
 
GRAND TOTAL
Total Amount