Registration Form
NCOA & SCOS JOint Membership
Conference
Three ways to register:
1. 	 Register online at www.ncoa-northca...
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North Carolina Oncology Association - NCOA/SCOS Joint Membership Conference

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North Carolina Oncology Association - NCOA/SCOS Joint Membership Conference

  1. 1. Registration Form NCOA & SCOS JOint Membership Conference Three ways to register: 1. Register online at www.ncoa-northcarolina.com or www.scosonline.com 2. Fax to the Executive office: 301.770.1949 3. Mail form to: NCOA & SCOS Conference 1600 Nebel Street, Suite 201 Rockville, MD 20852 First Name Last Name Institution/Affiliation Degree(s) Address City State Phone ZIP Fax Email address I will attend: n Conference, Friday, February 21, 12:00 pm - 5:45 pm n Reception, Friday, February 21, 5:45 pm - 6:45 pm n Conference, Saturday, February 22, 8:00 am - 3:00 pm Position: n Physician n Administrator n Nurse n Other n Pharmacist n Office Manager n Fellow Membership Status: n Member n Non-Member Special Services: n Vegetarian n Gluten Free n ADA: n Other: February 21-22, 2014 The Ballantyne Charlotte, NC

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