Mail completed registration form with check or money order to TSS to Jim Donaldson, 5050 Poplar Avenue, Suite 300, Memphis TN 38157
Registration Form:
TSS Annual Conference and Business Meeting
April 13th, 2012
Embassy Suites Cool Springs
Franklin, TN
Registrant Name: _________________________________________________________________
Title ______________(MD, PhD, RPSGT, RRT, etc)
Email address:___________________________________________________________________
Contact (phone) #_(______)________________________
(written confirmation prior to conference date cannot be guaranteed after March 31st without a valid email address)
Address: _______________________________________________________________________
TSS Member _____ Y/N Join TSS_____Y/N * PSG Student ______ Y/N
TSS Membership fee will be taken from Registration fee. Please complete and enclose membership registration. (Student registration requires proof of enrollment). Table seating during lectures is not guaranteed for last minute registry.
Contact Jim Donaldson at donaldsj@methodisthealth.org or
Rebecca Adams at maobfh@charter.net for more information.
□ Please check this box if you would like to be contacted by conference exhibitors.
