Registration ( Step 1 )

ONLINE REGISTRATION FEES
Diabetes Technology Meeting registration includes: Two Continental Breakfasts Two Lunches Two Evening Receptions Two Mid-Morning Snacks Two Mid-Afternoon Snacks One-Year Subscription to: “Journal of Diabetes Science and Technology”
Early Bird	GOV’T, HOSPITAL, UNIVERSITY ATTENDEE	GENERAL ATTENDEE
Meeting with No Pre-Meeting Workshop Meeting Commences 11/12/10 at 8 AM	$745.00	$985.00
Meeting Plus Morning Pre-Meeting Workshop A “The New Bundled World: Monitoring Diabetes Following Hospital Discharge”	$1245.00	$1485.00
Meeting Plus Morning Pre-Meeting Workshop B “Advances in Continuous Glucose Monitoring”	$945.00	$1185.00
Meeting Plus Morning Pre-Meeting Workshop C “New Ideas for Blood Glucose Monitoring”	$945.00	$1185.00
Meeting Plus Morning Pre-Meeting Workshop D “Insulin Pump Safety and Security”	$945.00	$1185.00
Meeting Plus Pre-Meeting Workshop A and C A) “The New Bundled World: Monitoring Diabetes Following Hospital Discharge” C) “New Ideas for Blood Glucose Monitoring”	$1445.00	$1685.00
Meeting Plus Pre-Meeting Workshop A and D A) “The New Bundled World: Monitoring Diabetes Following Hospital Discharge” D) “Insulin Pump Safety and Security”	$1445.00	$1685.00
Meeting Plus Pre-Meeting Workshop B and C B) “Advances in Continuous Glucose Monitoring” C) “New Ideas for Blood Glucose Monitoring”	$1145.00	$1385.00
Meeting Plus Pre-Meeting Workshop B and D B) “Advances in Continuous Glucose Monitoring” D) “Insulin Pump Safety and Security”	$1145.00	$1385.00

* Field must be completed

Person paying for registration (Same as Customer Billing Information )

First Name:*

Last Name:*

Attendee information:

First Name:*

Last Name:*

Academic Degree(s):*

Phone:*

Fax:

E-mail:*

Company/Institution:*

Address:*

City:*

Zip:*

State:*

Country:*

Diabetes Technology Society Photo, Video, Recording & Refund Policy

No photography or recordings will be permitted at this meeting. Anyone violating this policy will forfeit their registration privileges and will be asked to leave the meeting.

Space at the meeting is limited and you will be completely registered to attend only after payment is received. Attendees will be registered on a first-come, first-served basis.

Registration Refund Policy:

●	All refund requests must be made in writing
●	Refund requests postmarked before October 15, 2010 will receive a full refund LESS a 25% processing fee
●	Refund requests postmarked after October 15, 2010 will not be honored
●	Registration Modifications will be processed at the prevailing rate at the time of modification

Questions? Call 1-800-397-7755 or email info@diabetestechnology.org

* I HAVE READ THIS AGREEMENT AND AGREE TO ALL THE CONDITIONS ABOVE

Diabetes Technology Meeting

Registration ( Step 1 )