Registration Form

Canadian Rheumatology Association
Winter Workshop & Annual Meeting
February 20 (evening) to 23, 2002
Château Lake Louise


COURSE DETAILS

DEADLINE FOR REGISTRATION: February 5th, 2002
(course material cannot be guaranteed after this date)

*ACCOMMODATION MUST BE BOOKED BEFORE JANUARY 20th, 2002*
Fairmont Chateau Lake Louise
Phone 403-522-3511
Please make sure you indicate that you require accommodation in the Canadian Rheumatology
Association Room Block and that you are speaking with the Hotel and not their Call Centre.



PLEASE MAKE SURE TO CHECK OFF BOTH A FIRST
AND SECOND CHOICE FOR EACH WORKSHOP TIMESLOT.
Note: Space in each workshop is limited and will be assigned on a first come, first serve basis.
If you do not choose a workshop, one will be chosen for you based on availability
CHOOSE 1ST. and 2ND. CHOICE for Friday, February 22nd, 2002, 9:00 to 10:00 AM
Workshop Preference 1st 2nd
1) Update in scleroderma - case discussion
Chair: Janet Pope
2) Practical issues with the Anti-TNF therapies
Chair: Edward Keystone
3) Office Management - practical tips
Co-Chairs: Jamie Henderson & Carter Thorne
4) Musculoskeletal Pain Syndromes in Childhood
Chair: Ronald Laxer
Speaker: David Sherry
CHOOSE 1ST. and 2ND. CHOICE for Friday, February 22nd, 2002, 5:30 to 6:30 PM
Workshop Preference 1st 2nd
5) Update in Scleroderma - case discussion
Chair: Janet Pope
6) Practical Issues With the Anti-TNF Therapies
Chair: Edward Keystone
7) Office Management - practical tips
Co-Chairs: Jamie Henderson & Carter Thorne
8) Musculoskeletal Pain Syndromes in Childhood
Chair: Ronald Laxer
Speaker: David Sherry

PERSONAL INFORMATION

TITLE  
 SURNAME 
 FIRST NAME
ADDRESS
CITY
 		PROV/STATE
 		POSTAL CODE
DAY TELEPHONE
 		FAX NUMBER
EMAIL
DO NOT release my name to an attendee/ or industry member of this meeting



PAYMENT INFORMATION

METHOD OF PAYMENT
Send Cheques to
Continuing Medical Education
2J3 Walter Mackenzie Centre,
University of Alberta
Edmonton, Alberta T6G 2R7
VISA MASTERCARD CHEQUE
payable to University of Alberta
For Payment by Credit Card, please phone in your information at (780)407-6346 or fax it in at (780)407-1442.
Registration Fee
(Includes continental breakfasts, refreshment breaks and course materials)
AMOUNT BEFORE Feb 1/02
CRA Member $100 Non CRA Member $350
Trainee N/CVerification by supervisor must be attached		 AMOUNT AFTER Feb 1/02
CRA Member $150 Non CRA Member $400
Trainee N/C Verification by supervisor must be attached
AMOUNT BEFORE Feb 11/02
CRA Annual Dinner Ticket, Friday Night - $25
(CRA Member, Non-CRA Member and Trainees)
Number of tickets being purchased
 AMOUNT AFTER Feb 11/02 & ON-SITE
CRA Annual Dinner Ticket, Friday Night - $35
(CRA Member, Non-CRA Member and Trainees)
Number of tickets being purchased
Special Meal requests (vegetarian, gluten free etc.)
Type:
Thieves' Market - Thursday
Yes, attending No, not attending
Thieves' Market - Friday
Yes, attending No, not attending
Annual Ski Race - Friday
Yes, participating No, not participating
Kids/Teens Program
Yes, want more info No, not interested


Comments: