2024 IFSER Educator's Summit (ES) Registration  
Sign in to Google to save your progress. Learn more
Email *
July 12-13, 2024 Philadelphia, Pennsylvania
Hosted by Thomas Jefferson University
REFUND POLICY - I agree to the following terms: Refund of $200 through April 30, 2024. No refunds on or after May 1, 2024. *
Attendee's First Name *
Attendee's Last Name *
Street Address *
City *
State *
Zip Code *
Email address (for ES communications) *
ARDMS #
SDMS #
CCI #
ARRT #
Phone Number *
Date of Birth (for CMEs) *
MM
/
DD
/
YYYY
Will you be staying at the hotel chosen by IFSER - The Fairfield Inn & Suites by Marriott Downtown/Center City. 261 South 13th Street Philadelphia, PA 19107 *
Please indicate the days you plan to attend: 
Registration fee for Friday & Saturday :
Early Bird $375 on or before April 15, 2024
$425 on or after April 16, 2024 
$225 for one day attendance  
 *
Required
Please choose how you will be paying for the ES.

PLEASE NOTE - Registration is not complete until payment is made. Payment must be completed through a separate step. 
 *
To assist us in tracking registrations, please indicate the name of the person or organization who will be making the payment for this attendee. (If self, please state "self") *
Completion of this form is the first step in the registration process. *Please note: upon submission of this form, you will receive a follow up email with additional instructions on paying for the ES. *Your registration will not be complete until payment is received.  

 *
What college or hospital are you from or representing (include City and State)? *
PLEASE NOTE: With any food provided by IFSER, we cannot guarantee that we can accommodate for special food allergies, so please plan accordingly. Thank you.
*
How did you hear about the ES? Choose all that apply *
Required
IFSER PHOTO RELEASE

I hereby authorize the Board Members of the International Foundation for Sonography Education and Research (IFSER), and those acting pursuant to its authority to: 

(a) Record my likeness and/or voice on video, audio, photographs, digitally, electronically, or via any other medium. 

(b) Use my name in connection with these recordings, photographs, or any other means of capturing a likeness or voice . 

(c) Use, reproduce, exhibit, or distribute on the IFSER.org website, IFSER Newsletter, or any other IFSER promotional materials.

I release IFSER and those acting pursuant to its authority from liability for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such photos and/or recordings on the IFSER.org website, IFSER Newsletter, or any other IFSER promotional materials shall remain the property of IFSER.

I have read, understood, and agree to the above Photo Release and I affirm that I am at least 18 years of age.
 *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of IFSER. Report Abuse
Google Forms