Get Ct Colonography 2005 - Nyu Langone Medical Center - New York ...

Filling out the CT Colonography 2005 form accurately is essential for your participation in the workshop. This guide will provide you with clear, step-by-step instructions to ensure that your registration process is smooth and efficient.

Follow the steps to complete the registration form successfully.

1. Press the ‘Get Form’ button to access the registration form and open it for editing.
2. Begin by entering your personal details in the Participant Information section. Please print clearly the following fields: Name, Address, City, State, Zip, Daytime Phone, Fax, and Email. It is necessary to provide an email address if you wish to receive a confirmation receipt.
3. Fill out your Degree, Specialty, and Sub-Specialty fields in the respective areas provided.
4. Indicate your course preferences by selecting the checkbox for the April 22–23 class, or express interest in future dates if you cannot attend.
5. Review the tuition and fees section. Ensure you have the correct amount for the full course, which is $1750, including all provided meals and materials.
6. Complete the Cancellation Terms section to acknowledge the refund policy. Understand that the full tuition is non-refundable unless another applicant takes your place, with a $75 service fee applied.
7. Select your preferred method of payment. Fill in the necessary information for a check or credit card. If using a credit card, ensure to include Card Member’s Name, Card Number, Expiration Date, and Signature.
8. Send the completed Registration Form via fax to (212) 263-3959. Ensure that it is sent to the attention of Janice Ford-Benner.
9. In case of any questions, feel free to reach out to Janice Ford-Benner via email or phone as listed in the contact section.
10. Upon receiving your Registration Confirmation number from NYU, continue with your hotel and travel arrangements.

Begin your registration process by filling out the CT Colonography form online today.