Viruses in CFS Registration FormAlready registered? Need to edit? Click here
Please use this form if you are not registering for the main conference or only want to attend the Sunday morning sessions of the main conference (HHV-6 in CNS Dysfunction, MS, epilepsy & encephalitis).

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Personal Info  
Salutation *
First Name *
Last Name *
Nickname (for Badge)
Degree
Title/Position
Department
Organization *
Street Address Line 1 *
Street Address Line 2
City *
State/Province *
Country *
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Phone (Office) *
Phone (Mobile)
Dinner Option * Beef Fish Chicken
Special Diet * Vegetarian Kosher No Preference
Special Diet Details
Non-profit/Academic Rate - Includes 1-1/2 day seminar including Sunday dinner & Monday lunch - only $220 * Yes No
Standard/Corporate Rate - Includes 1-1/2 day seminar including Sunday dinner & Monday lunch - $285 * Yes No
Would you like to join our morning sessions on Sunday featuring HHV-6 in CNS Disease starting at 8:30 AM? Yes No
Would you like to join the main conference attendees for lunch on Sunday at 1 pm for additional? Yes No
Coupon Code
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If you know a colleague who may be interested in attending this conference as well, please type his/her email address
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