Registration Form 2024

Link to PDF Registration Form: Registration Form 2024.pdf

Link to Online Registration Form: https://docs.google.com/forms/...


Physicians………………………………………….250 Prior to Dec. 31, 2023, Thereafter $400

 

Other Healthcare Professionals………………………………………………………….....…$150

 

ISCVDP Members and Previous Attendees limited to 100 Prior to Dec. 31, 2023………$100

 

Medical Students and Nurses (first 50 registrants), prior to Dec. 31, 2023.………………Free

 

Public invited free for Saturday Afternoon session. Space is limited, must pre-register

 

 

Optional Lunch for Health Care Providers by invitation: Friday February 2, 2024

YES, I will attend

NO, I will not attend

Optional Dinner for Health Care Providers by invitation: Friday February 2, 2024

 

YES, I will attend

NO, I will not attend

Optional Breakfast Program by invitation: Saturday February 3, 2024

 

YES, I will attend

NO, I will not attend

Optional Lunch for Health Care Providers: Saturday February 3, 2024

YES, I will attend

NO, I will not attend

Optional Dinner for Health Care Providers by invitation: Saturday February 3, 2024

YES, I will attend

NO, I will not attend

 

Make checks payable to: International Society for Cardiovascular Disease Prevention

Prevention and mail to the address below. *

FOR CREDIT CARD PAYMENT CALL (941) 366-9805

Name: ___________________________________________________

Title: _____________________________________________________

Address: __________________________________________________

City: _____________________________State: _____Zip: __________

Facility: ___________________________________________________

Phone: ___________________________________________________

E-mail: ___________________________________________________

Name on Card______________________________________________

Card No. ____________________________________Exp____/_______

 

Send Registration Form & Appropriate Fee to:

International Society for Cardiovascular Disease Prevention

P.O. Box 433, Sarasota, FL 34230

Attn: M. El Shahawy, MD, Program Director