2007 Educational Programs Registration Form

Please fill out the following information below and then press the submit button.

Name:
Institution:
Address:
City:
State/Province:
 Country: Postal Code:
Phone Number:
Fax Number :
Cell Phone :
Email Address:
Physician EP Nurse EP Technician Biomedical Engineer Other
 

Tuition Payment
Credit Card
(Please Call Educational Services 800-537-6285)
Check*
Included with sale of EP-WorkMate® System **
Other
Purchase Order
  Order Number
   
 
Course Selection - 2007
Advanced Application Course | EP-WorkMate®
ES - 02 | $1500 / Attendee
January 17-18 May 23-24 September 19-20
March 21-22 July 18-19 November 7-8
 
Advanced Application Course | EP-WorkMate®
ES - 03 | $2000 / Attendee
April 24 - 26 August 21-23 December 4-6
 
Advanced Application Course | EP-WorkMate®
ES - 04 | $1000 / Attendee
January 11-12 May 17-18 September 13-14
February 15-16 June 14-15 October 11-12
March 15-16 July 12-13 November 15-16
April 12-13 August 16-17 December 13-14
 

Introduction to Electrophysiology Pre-Course - ES-02 EP

This course may be added to any of the above selected courses.

$500 / Attendee
 
   
 

Please fax purchase orders to (856) 753-4683

EP MedSystems, Inc. will email you a registration confirmation upon receipt of your registration form and tuition payment.
Class sizes are limited and are confirmed on a first come, first served basis.
Registration Cancellations or Rescheduling require 7 calendar days notice.

* Credit Card and Check Payment Methods Require a No Charge Purchase Order
** Tuitions included with the sale of a system expire 18 months from system installation