Medical Missionaries 2010 Medical Mission Conference Online Registration

• Friday, November 12th:  7-9 p.m.
• Saturday, November 13th:  8:00a.m. -
• Sunday, November 14th:  8:00 a.m. - 3:30 p.m.

Location:  Prince William Hospital Conference Center, 8700 Sudley Rd., Manassas, VA  20110 

Name of Registrant:  * required Contact Information:  * required  * required  * required  * required  * required  * required I am attending the conference as a (please check one): Doctor $150 Nurse $100 Student $75 Other $100 Will you be attending the opening session on Friday, November 12th from 7-9 p.m.? (Select one from the drop-down menu). I will attend the opening session on Friday, November 12, 2010 I will NOT attend the opening session on Friday, November 12, 2010 Do you represent a non-profit or a religious missionary group? Yes* No *If yes, please provide the following information: If you would like information about your organization included in our handout materials, please email then to Ken Kornetsky, MD at kkornetsky@msn.com.

Please submit your registration fee online using Paypal. 

• Doctors: $150
• Nurses: $100
• Students:  $75
• Others:  $100

Thank you for registering for the 2010 Medical Mission Conference!