Registration

The registration fee for this workshop is being supported by educational grants from industry. For out-of-town attendees, we will provide lodging, including room and tax, at the W Hotel for the nights of Thursday, August 13, Friday, August 14 and Saturday, August 15. In addition, the course will provide a travel stipend for the residents to travel to and from Seattle. Meals outside of course functions, uninvited guests and other miscellaneous expenses are not reimbursable and are the responsibility of the attendee. 

By submitting the registration below, I certify that I am beginning my fourth year Neurosurgical Residency/Fellowship on or before July 1, 2015, and that my program director has approved my registration for this course.

Applicant Name *
Applicant Name
Applicant's Address
Applicant's Address
Applicant Phone (Mobile Preferred)
Applicant Phone (Mobile Preferred)
This phone number will be used to get in contact with you during the course.
Program Director's Name *
Program Director's Name
Please provide the name of your program director.
Program Director's Phone *
Program Director's Phone
Program Coordinator's Name *
Program Coordinator's Name
Please provide the name of your institution's program coordinator. They will be contacted to help complete your online registration.
Program Coordinator's Phone *
Program Coordinator's Phone