international veterinary seminars-Costa Rica
Secure Order Form

Select the appropriate registration below that you would like to order. Your transaction will be confirmed by email and a seminar confirmation will also be e-mailed to you. Costa Rica: earlybird by Dec. 18 ($ 655.00 each) Costa Rica:advanced by Feb. 5 ($ 675.00 each) Costa Rica: regular ($ 695.00 each)

GENERAL INFORMATION

First Name:	Last Name (DVM VMD):
Address:
City:	State: Zip:
Country:
Phone Number:
E-Mail Address: