CME & CULTURAL TOUR OF NORTH INDIA
 
OCTOBER 25 - NOVEMBER 11, 2019
 
PRE - REGISTRATION FORM
 
 
 NO DEPOSIT REQUIRED ! 

      GROUP MEDICAL DIRECTOR:      
   DR. PETER BLOCH, OAKVILLE, ON. 
 
 

Registrant Information

    

Number of rooms required: *

Contact Information


Click the optional button below to print a copy of your form for personal records. You must still click the Submit button below to complete your pre-registration.