North Carolina College of Emergency Physicians

Registration Information

First Name*

Last Name*

Preferred Name for Badge*

Role*

Role - Other*

Affiliation*

NPI Number*

This is used to report CME credit hours attended.

Address*

Street Address City State ZIP Code

Phone*

Email*

Reception and Box Lunches

Will you be attending the reception on Monday:*

Number Attending Reception*

Please enter a number from 1 to 6.

Please indicate whether you would like lunch:

Monday
Tuesday
Wednesday
None

Will you attend the Pediatric Cardiac Ultrasound and Workshop on Wednesday morning? (Included in conference registration.)*

Registration Fees

Conference Registration*

Full Conference
Individual Days

Registration Type*

Days Attending*

Monday, November 7
Tuesday, November 8
Wednesday, November 9
Thursday, November 10

Coupon

Total

$0.00

Pay by:*

Check
Credit Card

Credit Card

Card Details

Cardholder Name

For more information, or to submit your check, contact:

Liz Taylor
Asst. to Executive Director
North Carolina College of Emergency Physicians
PO Box 1038
Wake Forest, NC 27588
events@nccep.org

**Please note that no printed copies of the course syllabus will be provided at the conference. Lecture materials will be provided in an electronic format prior to or at the conference. Please consider bringing a laptop or tablet if you would like to view the presentations during the lectures.

PLEASE NOTE: YOU WILL NOT RECEIVE A CME CERTIFICATE UNLESS YOU COMPLETE THE OVERALL ACTIVITY EVALUATION.

2022 NCCEP Fall Conference Registration

2022 Fall Conference Registration

Registration Information

Reception and Box Lunches

Registration Fees