GaPQC Virtual Conference Registration October 14 & 15, 2021 8:00am – 1:00pm If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Email * Cell Number * Name of your hospital / department you represent * What days will you attend? * Day 1Day 2I will attend both days All confirmations, meeting materials/handouts, and links to the conference will be sent to the email address provided. It may be necessary to check your "spam" folder for this email. *Materials and conference link will be sent out by 10/12/21. COST: $75.00 per registration At the conclusion of this form you will be directed to PayPal to pay with your credit card. Registration is not complete without payment.
