Biotechnology: From Bench to
Bedside
Thursday, May 1, 2008
8:30 a.m. - 3 p.m.
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Personal Information
Name:
__________________________________________________________________
Company:
________________________________________________________________
Address:
________________________________________________________________
Telephone: ( ) ______
- __________ Fax: (
) ______ - __________
E-mail Address: __________________________
Registration Fees
$75 - Biotechnology Industry
$25 - Academic
Payment
Pay by Check
Please make check or money order payable to: St. John's University
Total enclosed: ______
Pay by Credit Card
Check one:
| [_] Visa | [_] Discover |
| [_] Mastercard | [_] AMEX |
Card #: ___________________________ Name on card:
__________________________
Exp. Date: ______________ Signature:
________________________________________
Mail to:
Dr. Diana Bartelt
Institute for Biotechnology
St. John’s University
8000 Utopia Parkway
Queens, NY 11439