EXHIBIT REGISTRATION FORM
38th Annual Dr John C Weed OB/GYN Resident Research Seminar
June 10, 2022
Phyllis M and Patrick F Taylor Auditorium, New Orleans, LA

Company Name

Contact Name

Address

Email

Phone Number

Representatives Participating in Event:

NAME	EMAIL

LOCATION:

EXHIBIT Fee:

Table Exhibit - $2,500

• 5 spots available
• Exhibit Table outside of the Auditorium

Lunch (Food & Beverage Expense)

NO ELECTRONIC or ACH PAYMENT CAN BE ACCEPTED FOR THIS EVENT

Check	Make checks payable to Ochsner Clinic Foundation - Tax ID #72-0502505 Mail to: Ochsner Clinic Foundation Continuing Medical Education Attention: Kristin Tschirn 1401A Jefferson Highway New Orleans, LA 70121
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