The SF Neurological Society is a CMA-accredited provider of Continuing Medical Education

 60th Annual Meeting of the  San Francisco Neurological Society
 Friday, March 14 - Sunday, March 16, 2008 -  Hyatt Regency Monterey, Monterey, CA
 Registration Form

First Name                                                Initial              Last Name                                                                            

Degree          Specialty __ Neurology __ Neurosurgery __ Neuroradiology __ Neuropathology __Other___________________

Institution                                                            Dept/Mailstop                                                                                   

Street Address/Suite                                                                                                                                                   

City                                                                   State                 Zip Code                                                                  

Phone                                                                             Fax                                                                                    

*E-mail: (VERY IMPORTANT)                                                                                                                                

Registration Fees: (please check the appropriate boxes)

                                              By March 6  After March 6 and onsite

SFNS Member Meeting:        __ $140.00    __$160.00 (Includes CME, Syllabus, President’s Reception, Breakfasts & Coffee Breaks)

Non-Member Meeting:          __ $215.00   __ $235.00 (Includes all of above plus 2008 SFNS Membership)

Allied health Professional: __ $115.00   __ $125.00 (Includes Syllabus, President’s Reception, Breakfasts & Coffee Breaks)   

*Resident/Fellow                   __$25.00     __ $45.00 (Includes CME, Syllabus, President’s Reception, Breakfasts & Coffee Breaks)                                            
*(Please e-mail a letter of training status to kbertani@sfneurological.org)

Accompanying Person          __ $65         __ $65 (includes President’s Reception and Breakfasts)       
Children under 12 are FREE and welcome to attend the President’s Reception and Continental Breakfasts

Saturday Evening Reception & Society Dinner $85 per person: ___people X $85.00 each = $               

__  SF Neurological Society Membership Renewal for 2008 - $75.00 (2008 Membership dues must be current to obtain the SFNS Member discounted registration fee.)

 Name(s) of Guest(s): (please print)

 Payment Total: $                                                        Name of Accompanying Person:                                          

Payment Method: __ Visa    __ Mastercard      __ American Express     __ Check Payment Total: $                         

 Card Number                                                                            Expiration Date                                                              

Cardholder Name                                                                      Signature                                                                       

Special Needs: If you need special arrangements, such as a special diet or accessibility assistance, please call 415-206-9603 or e-mail kbertani@sfneurological.org or fill in here:

 The SF Neurological Society is incorporated as a 501(c) (6) non-profit organization. Tax ID number: 51-0478773. 

• Register online (and/or renew/enroll SFNS Membership dues online) and make secure credit card transactions or print a personalized invoice to mail in with a check -

• Fax your registration form and credit card information to the SF Neurological Society 415-206-0385

• Mail the registration form with a check made out to San Francisco Neurological Society, 2226A Westborough Blvd. #409, South San Francisco, CA 94080 

Cancellations made by March 8, 2008 will receive a full refund less a $25 handling fee. No refunds can be made after March 8th as hotel guarantees will have been made. Cancellations must be made in writing by e-mail to kbertani@sfneurological.org or by FAX to 415-206-0385.

Exhibitors & Unrestricted Educational Grants

Hotel & Reservations

Board of Directors

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