HHS Advisory Committee on Organ Transplantation

Meeting Registration

May 5 - 6, 2008 Hilton Washington, DC/Rockville Executive Meeting Center 1750 Rockville Pike Rockville, MD 20852 Main (301) 468-1100

REGISTRATION FORM

Your presence is requested at the Advisory Committee on Organ Transplantation (ACOT) Meeting! This will be a two-day event taking place at the Hilton Washington, DC/Rockville Hotel in Rockville, MD. Please take a moment to fill out the registration form below and submit to Amanda Madeline via email at a_madeline@team-psa.com or facsimile at (703) 234-1701.

Please Register Before April 21, 2008

Meeting registration: Download registration form (PDF - 47KB) complete and send, including the following information, to a_madeline@team-psa.com or fax 703-234-1701.

• Participant's full name

• Participant's name as it should appear on the name badge

• Title

• Organization

• Full mailing address, including number and street, city, state and zip code

• Phone number

• Fax number

• e-Mail address

• Any special needs related to physical disabilities, dietary restrictions, etc.

If you have any questions, please contact Amanda Madeline of PSA at 703-234-1244.

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