2009 SNMA Region II Pre-Medical Forum - Hosted by University of Illinois at Chicago

Conference Welcome

Conference Schedule

Student Registration

Exhibitor Registration

Housing

Maps and Travel Information

Conference Contact Information

UIC-COM

UIC SNMA

UIC Urban Health Program

Information about Chicago

Information about Chicago from UIC Students

Region II Website

2009 SNMA Region II Pre-Medical Forum Registration

Fee Structure:

Register before Friday, March 13th, 2009!

Non-SNMA & MAPS Members	$45.00
SNMA & MAPS Members	$35.00
High School Students	$15.00
University of Illinois at Chicago Students	HALF PRICE REGISTRATION!

** The National Membership Application is available online at www.snma.org.

Registration Deadlines:
Register by Friday, March 13, 2009 at 11:59 PM
(Postmarked or Online).
Registration will remain open until the Pre-Medical Forum!
(Postmarked or Online).

Mailing Address:
UIC-COM Urban Health Program
Attn: Region II SNMA/MAPS Conference
1819 W. Polk Street
145 CMW (M/C 786)
Chicago, IL 60612-7333

*First Name:
Middle Initial:
*Last Name:
*Telephone Number (1): (in 10-digit format, e.g. 6625551212)
Telephone Number (2):
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip Code:
*E-mail Address:
School:
If you specified a school other than a Region II SNMA or MAPS school, please list it here:
SNMA Member Number: (required for member pricing!)
Student Status:
If your student status is "other", tell us where you are in school:
*Graduation Year: (all 4 digits, e.g. 2008)
Please List Any Dietary Restrictions:
Do you plan on attending the Friday night social?
Payment Method
By clicking below, you are agreeing to the following: 1) I plan to attend the 2009 Region II SNMA Pre-Medical Forum being held in Chicago, IL. I will not be considered registered until I have submitted payment for the conference. If I am unable to attend, I understand that there is no refund of the registration fee after it has been submitted. 2) It is okay to email the registration confirmation approximately one week prior to the conference, and the signature allows for the confirmation to be received in this way. I understand that my payment must be postmarked (if mailing), or electronically submitted by March 13, 2009. 3) Yes, I authorize the region to use my pictures in future SNMA publications, regional or national.