Conference Registration

Section 1. Personal Information

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• First NameMiddle NameLast NameTitle------BSMSPhDMDMD, PhDMD, MPh
• InstitutionDepartment
• Street AddressAddress Line 2
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• Work PhoneFax
• Email

Section 2. Registration Information

• The registration fees covers attendance at all scientific sessions.

Check one from each sub-section if applicable.

• Category

  The registration waiver for "Invited Speakers" is available only to those who were never been members of the Society and were formally invited to give a talk

  Registration will automatically enroll the individuals as SNIP members for one year, however the individuals for whom the registration fee is waived off will be exempt from the membership.

  Category		Early-bird till 20 Jan	Regular 21 Jan - 20 Feb	Late 21 Feb - 6 May
  	Non-SNIP Member	$800	$850	$900
  	SNIP Member (including $125 membership renewal)	$725	$775	$875
  	SNIP Member (already paid new membership fee)	$600	$650	$750
  	Patron Member (Description Here)	$600	$650	$750
  	Res. Assoc./Undergrad/Grad/Med Students (including $60 membership)	$200	$225	$250
  	Postdoc/Residents (including $60 membership)	$225	$250	$275
  	Invited Non-member Speakers	$0	$0	$0
  	Pre-approved Travel Grant Awardees	$0	$0	$0
  	Pre-approved Emeritus	$0	$0	$0
  * If you are not a current SNIP member, you may apply for membership application (https://s-nip.org/members) BEFORE registering as a SNIP member.
  Attendees under all these categories may bring their guests by registering them. The registration fees for the accompanying guests is as follows:
  	Guest	$150	$150	$150
  	No	—	—
  Guest Name:

• Special Accommodations

  Check if you would need special accommodations