Bioethics Intensive Course: Registration and Payment

Bioethics Intensive Course Registration and Payment
REGISTRATION
Name*

First NameLast Name
Credentials*
Email*
example@example.com
Organization Name*
Organization Address*

Street Address

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PAYMENT
Are you registering along with two or more participants from one institution? (Note the multiple participant discount in pricing below.) Each participant will fill out their own registration form.*

YesNo

My Products

General Registration

$1,600.00

Trainee Registration (Resident / Fellow / Student)

$1,200.00

Employee / Affiliate Employee Registration (Baylor College of Medicine/ Houston Methodist / Baylor St. Luke's Medical Center, St. Luke's Health, CommonSpirit Health)

$1,200.00

Registration along with two or more participants from one institution. (If you checked "yes" above.) Price per individual.

$1,400.00

Total

$0.00

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Pay by Check

Your course registration will not be final until payment is received.

Checks should be made out to Bioethics Intensive Course 2023 and mailed to:

Meredith Trejo
Administrator
Center for Medical Ethics and Health Policy
One Baylor Plaza, Suite 310D
Houston, TX 77030
Should be Empty:

Bioethics Intensive Course Registration and Payment

REGISTRATION

PAYMENT

Pay by Check