"Minorities in Medicine: Past, Present Future ”
SNMA Region IX Annual Conference
SUNY University Medical School
Exhibitor Pre-Registration Form
Prefix
Mr
Mrs
Ms
Dr
First Name
Middle Name
Last Name
SNMA Membership # (if applicable)
Address
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Email
Phone
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School/Business Affiliation
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Registration Fee
Exhibitor: $200.00
Additional Cost
Kaplan Practice MCAT: $5.00
Jazz Mixer Tickets: $5.00
Contribution Amounts