BCF Logo

 

Breast Cancer Foundation
Event Registration

Please select the event
registration you would like to complete:    

 

 

First Name: Last Name: Title:
Address:
City: State: Zip: County:
Daytime Phone #: Fax #:
Email Address:

Name of Employer/Organization:
Employer/Organization Address:
City: State: Zip: County:

Years of Experience in Mammography:

Registration Fee:  $99—Please make check payable to Breast Cancer Foundation

A $40 administrative fee will be deducted for written cancellations postmarked prior to March 30, 2012. 
No refunds for cancellations postmarked after March 31, 2012.  The registration fee includes lectures, breaks, course manual and a certificate of attendance.  Attendees will be on their own for lunch.  There are several restaurants in the area as well as one in the Hilton Garden Inn.

Make checks payable and return to:
                        Breast Cancer Foundation
                        c/o Medical Imaging Physicians, Inc.
                        2591 Miamisburg Centerville Road, Ste. 302
                        Dayton, OH 45459

You will receive a confirmation notice after registration has been processed.

Seminar Location:
                        Hilton Garden Inn
                        3520 Pentagon Blvd.
                        Beavercreek, OH 45431
                        Phone: (937) 458-2640

Foundation has reserved a block of rooms at Hilton Garden Inn, room rate $111. Please call Hilton Garden Inn.

BOWL OVER CANCER August 4, 2012

For mor information about Bowl Over Cancer, contact Kathy Haught at (937) 227-9422

Team Name:

Bowler 1: (Captain)
Bowler 2: