Symposium Registration Form

Carotid Atherosclerosis Imaging:
Application in Clinical Trials and Natural History Studies
September 26^th, 2008, Seattle, WA

Free for students and faculty, $100 for industry representatives and scientists.

If you are paying in advance, please send a check to:

Vascular Imaging Laboratory
815 Mercer St.
Box 358050
Seattle, WA 98109

Otherwise, cash, check or credit card will be accepted at the door.

First & Last Name:

Institution/Company:

Department:

Address:

Telephone Number:

Email Address:

Confirm Email:

How did you hear about the symposium?

Registration Type: Note that the fee can be paid in advance or at the door. See above for details.

Student/Faculty (no fee)
Industry ($100 fee)