Registration

Meeting Registration

• Please select if you will attend in-person or virtually:
• --Select-- In-Person Virtual

• Registration Categories
• Early Discounted
  through 1/4/2024
• Regular Fees
  after 1/4/2024
• Member — In-Person
• $425
• $475
• Nonmember — In-Person
• $475
• $525
• Fellow — In-Person
• $200
• $250
• Resident/Medical Student — In-Person
• $100
• $150
• Member — Virtual
• $525
• Nonmember — Virtual
• $575
• Fellow — Virtual
• $250
• Resident/Medical Student — Virtual
• $150
• Industry Employee - Supporting/MSL
  Industry Employee whose company is already supporting SWIU OR Industry Medical Science Liaison
  (Proof of MSL Title may be required before confirmation of registration)
• $475
• Industry Employee - Non-Supporting
  Industry Employee whose company is NOT already supporting SWIU
• $1,750
• Your submission will need to be approved prior to confirmation of your registration. Approval may be based on current Industry support. To find out if your company is a current supporter, please contact JP Baunach in the Industry Relations Department at jp@wjweiser.com.

Registrant Information

• First Name
• Last Name
• Degree(s)
• Badge First Name
• Email entered must be used to log in to the meeting
• Phone
• --Select Address Type-- Home Office Address Type
• Company Name
• Country
• Address Line 1
• Address Line 2
• Address Line 3
• City
• State/Province
• ZIP/Postal Code
• -- Select How Heard About Event -- Advertisement in Professional Journal Calendar/Monthly Listing Email Member Newsletter Registration Brochure Mailer Website Word of Mouth/Colleague How did you learn about this conference?
• -- Select Category -- Urologist Nonphysician Provider Urology Fellow Urology Resident Other Medical Professional Full-Time Administrator Industry Employee Student/Trainee Category that best describes your status
• Program Name
• -- Select Grad Year -- 2023 2024 2025 2026 2027 2028 2029 2030 Expected Graduation Year

• TOTAL PAYMENT DUE: