Registration

Hawaii Plastic Surgery Symposium 2018

Hawaii Prince Hotel

February 17-18, 2018

Registration Fees:

Early Bird (until Sept 17, 2017)....$500

Regular Online (after Sept 18, 2017)....$550

Allied Health Professionals....$200

(registration fee includes breakfasts, lunches, and a welcome dinner reception)

Payment methods:

1. By check or money order:

payable to Pan-Pacific/Plastic Surgery Symposium in U.S. funds and mail it to Dr. Kosasa at the following address:
Tom Kosasa, MD, Pan-Pacific/Plastic Surgery, 1212 Punahou St #3506, Honolulu, HI 96826.

2. By credit card faxed to Dr Parsa's office: +1.808.536.8836

3. By credit card online:

Please fill out the FORM BELOW

First Name:*

Last Name:*

Degree:

Address:*

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip CodeCountry

Phone:*

Area Code

Phone Number

Fax:

Area Code

Phone Number

E-mail:*

Registration Fee:*

Surgeon

AHP

Resident/Student

Total:

Word Verification: