Tennessee Perfusion Association 2008 Annual Meeting

 September 12^th - 13^th

Please Print and Mail This Membership/Registration Form

Name:__________________________________________E-Mail:_____________________________________

Address:____________________________________________________________________________________

Status: (Circle one): Perfusionist  --  Non-Active -- Student (free)

Category I CEU's Available:  TBA

September 12^th -  Harpeth Hills Golf Course:               Yes     No

(Golf Tournament will begin at 7:00am)

September 12^th – Friday Session: Baptist Hospital (TBA - CEUs):          Yes     No  

(Friday session will begin at 1:00 pm)

September 13^th – Saturday Session  Baptist Hospital  (TBA - CEUs):       Yes     No

(Saturday session will begin at 8:00 am)

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Meeting Agenda and Locations are HERE.

Pre-registration:  (Prior to September 7^th, 2008):  $50.00

Late Registration:  $250.00

Please make registration fee payable to:                 TPA

Please Send This Registration Form and Fee To:         Harry Moneypenny

                                                                                           1603 Knox Ct

                                                                                           Brentwood, TN 37027 - 7343

**Cancelled check is receipt**