“ Developing Clinical Highlights
Data Elements for SPL ”
Workshop

Fax and Mail Registration Form

April 2 & 3, 2007

Please register me for: “ Developing Clinical Highlights Data Elements for SPL ” Workshop, April 2 & 3, 2007 Sheraton Hotel, King of Prussia, PA, USA - Fee: US$ 1,995.- The fee includes workshop material, 2 continental breakfasts, break refreshments, 2 luncheons. The fee does not include dinner, accommodation or transportation.
Personal Information: £ Ms. £ Mr. £ Dr.	Method of Payment: £ CHECK enclosed (US funds drawn on a US bank; payable to Quadrant eLabeling Services LLC) £ CREDIT CARD £ Visa £ MasterCard £ AMEX Card #: ___________________________________ Expiration Date: _____ / _____ Signature: ___________________________________ (required)
Name:
Title:
Organization:
Mailing Address:
Telephone:
E-mail:
Full payment must accompany the registration form. Registrations accompanied by a personal check must be received 2 weeks before the event. Confirmation is sent via email. Cancellations: Cancellations made by participants within 14 days of a workshop will be subject to a 50 % cancellation fee. If the workshop is not held for any reason, Quadrant eLabeling Services LLC’s liability is limited to the refund of the workshop fee.

How to register:

By phone: Please call Quadrant eLabeling Services LLC (QeL) at: +1 (610) 353-4424

By fax: Fax the completed registration form to QeL: +1 (610) 903-4411

By mail: Mail the completed registration form (with check, if applicable) to
Quadrant eLabeling Services LLC, 355 Lancaster Avenue, Building E, Haverford PA 19041, USA.

Venue Information:

Sheraton Hotel, King of Prussia, PA 19406.

Tel: (610) 878-1460 Fax: (610) 337-4506 .

For hotel reservations, please contact 610-878-1460 and ask for Karen Vincent.

Special room rates for Quadrant eLabeling Services Workshop offered.

Directions available at www.qelabeling.com/W1.htm.