Vendor Workshop Form

Vendor Workshop Form
Please indicate for which workshop(s) you are applying for:*
- Workshop 1: Lung Ultrasound Saturday October 29 2014 from 8:00 to 11:45 am
- Workshop 2: Anesthesia for Airway Surgery and Interventional Procedures Saturday October 29 2014 from 8:00 to 11:45 am
- Workshop 3: Simulator Workshop for Rare and Critical Events in Thoracic Anesthesia Saturday October 29 2014 from 8:00 to 11:45 am
- Workshop 4: Paravertebral Blocks Saturday October 29 2014 from 8:00 to 11:45 am
- Pig Lab Saturday October 29 2014 from 8:00 to 11:30 am
The workshop is $40.00. How would you like to pay
- Please invoice me paypal.
- I will mail a check : Saga Building, 7th floor Damascus Road, Saifi District Beirut, Lebanon
- I understand the Deadline is October 20, 2014, I realize this is a first paid first secured spot.

Your Company Name