Georgia Emergency Medicine
Leadership & Advocacy
Conference
Hotel Information
Attendee Registration
Exhibitors
 
2018 Rural Emergency Practice Conference
Agenda
Hotel Information
Attendee Registration
Speaker Form
Exhibitors
 
 
Courses
GCEP Emergency
Procedure Course
 
Past Meetings
Speaker Handouts
Patrons
2018 Rural Emergency Practice Conference
February 10 - 11, 2018
Mercer University School of Medicine
1250 East 66th Street
Savannah, GA 31404

Speaker Form

Speaker Name: *
Email Address: *
Required entries with every submission*


Contact Information

Mailing address:
Office Phone:
Mobile Phone:
Home Phone:
Fax:
Assistant's Name:
Assistant's Phone:
Assistant's Email
Address:



Please list how you wish to be listed in the program


BIO (used in the Meeting Program and excerpts taken for verbal introduction)



TRAVEL
GCEP will either pay a $125 honorarium OR a 1 night stay at the hotel. Please check below which you would prefer:
    $125 honorarium (we will provide you with a check at the meeting)
    1 night stay at the hotel (room and tax will be put on our master bill)

If choosing a hotel stay please indicate your check in and check out date.
   Check in Date:
   Check out Date:

Please fill out the following to continue