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CSIMS 36th Annual Conference
Start date : October 21, 2021
End date : October 24, 2021
This registration is restricted to members only.

First Name*:
Last Name*:
Email*:
 

(Please use the same email that you used at the time of your membership registration.)


Designation*:

If Other, please specify:
Cell Phone (e.g. 5554441212)*:
Alternate Phone (e.g. 5554441212):
Are you a QME?*:
Name on Badge as you would like it to appear*:
Any Special Needs:
Name of Guest 1:
Name of Guest 2:
 

(If you have more guest names to add, please contact us at [email protected].)

 
 
 
  *EVENT REGISTRATION OPTION
 
SrNoOptionSelectCost
31593657Active Member (includes full conference & Saturday night extravaganza): $595.00595.00

  ADDITIONAL OPTIONS

OptionHow manySelectCost
31593658Guest/s - Spouse/Staff (full conference & extravaganza- No CME/CE/QME credits): $195.000195.00
 
                                                                                              Total    
 
 
 
 *PAYMENT METHOD
 
Enter Name on Credit card* :
 
 
 PAYMENT TERMS

You do not need a PayPal account to pay via credit card. 

HOTEL RESERVATION

Book Your Hotel: https://book.passkey.com/gt/217959011?gtid=9d8076b42f1f66a508c964759734683b

No codes needed

 
 CANCELLATION TERMS

For the 36th CSIMS Annual Conference on October 21-24, 2021 there are no cancellations allowed. Once your membership is verified and your conference fee is collected, all of the presentations will be made available to all registrants at no additional cost.


Technical Support:

If you have any problem submitting the form, please contact [email protected]

Membership and Conference Questions:

For any other questions regarding Membership and the 36th CSIMS Annual Conference on October 21-24, 2021, please contact:

Patricia Aranas

CSIMS Assistant Director

C: 949-525-9102 or 559-285-1433

E: [email protected]

 
   
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