Your Name (required)

Title
DVMVMDMDDPMTechnicianRDMSOffice Manager

Company

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Address 2

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License Number for CE Credits (You MUST be a licensed veterinarian or veterinary technician to register).

Number of Attendees
1234

Attendee #2

REQUIRED - Attendee #2 License Number for CE Credits

Attendee #3

REQUIRED - Attendee #3 License Number for CE Credits

Attendee #4

REQUIRED - Attendee #4 License Number for CE Credits

Course Name
July 27 & 28, 2013 - Basic Abdominal - Panoma, CAAugust 24 & 25, 2013 - Intermediate Cardiac - Panoma, CAOctober 5 & 6, 2013 - Basic/Intermediate Abdominal - Raleigh, NCOctober 19 & 20, 2013 - Basic/Intermediate Abominal - Baton Rouge, LAOctober 26 & 27, 2013 - Basic Abdominal - Bedford Hills, NYNovember 2 & 3, 2013 - Basic/Intermediate Abdominal - Fort Collins, CODecember 14 & 15, 2013 - Intermediate Cardiac - Bedford Hills, NY

Note: Web registries for sold out dates will be added to waiting list. NC State, OSU, Illinois, LSU - Baton Rouge and Wisconsin courses are NOT included as part of any Universal Education Package. Separate fees apply.

Current U/S System

Payment Method
---Prepaid (Education Package with System Purchase)Contact me for Credit Card Info

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Upon submission, Universal will review your registration and contact you for payment information. SUBMISSION OF THIS FORM IS NOT A CONFIRMATION OF CLASS REGISTRATION.