For Educators

Register for 05/14/2014, 8:45am EST VIEW ONLY Surgical Suite: Total Knee

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Email Address

Registration Code

Surgical Suite: Total Knee PLEASE NOTE ALL TIMES BELOW ARE LISTED IN EASTERN TIME (EST)

Event Date/Time

05/14/2014 @ 8:45am - 10:30am

Please choose a test connection from the times listed below. PLEASE NOTE ALL TIMES BELOW ARE LISTED IN EASTERN TIME (EST). COSI suggests testing before your first session with us each school year. After that, you may opt out of the test connection. If you do choose to opt out and experience technical issues the day of the program, you may still be responsible for the full cost of the program.

IP Address

Port or Extension

Dial In or Dial Out

Test connection appointment time

Cost of the program includes 1 kit of materials for up to 30 students. If you would like to purchase any additional kits, you may do so here.

$105.00@

Additional Kit of Materials

-$30.00@

No Kit

This is the address where we will ship your kit of materials. No P.O. boxes please.

Organization Name*

Organization Address*

Street Address

City

State / Province / Region

Postal / Zip Code

County

Country

Organization Name

Name*

First

Last

Title/Role

Address

Street Address

City

State / Province / Region

Postal / Zip Code

Country

Email Address*

Phone Number*

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Fax Number

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Number of Students

Grade Level

Copy values from the previous contact.

Organization Name

Name*

First

Last

Title/Role

Address

Street Address

City

State / Province / Region

Postal / Zip Code

Country

Email Address*

Phone Number*

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Fax Number

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Copy values from the previous contact.

Organization Name

Name

First

Last

Title/Role

Address

Street Address

City

State / Province / Region

Postal / Zip Code

Country

Email Address

Phone Number

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Fax Number

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Copy values from the previous contact.

Organization Name

Name*

First

Last

Title/Role

Address*

Street Address

City

State / Province / Region

Postal / Zip Code

Country

Email Address

Phone Number*

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Fax Number

e.g.: 555-123-4567, or 555-123-4567 ext. 890

Below are your estimated fees for this program. Your invoice will be sent to the billing address provided above.

  Estimated Total
$0.00
  Video Conference Connection @ $285.00   $285.00
  Additional Kit of Materials @ $105.00  
  No Kit @ -$30.00  

Please add any additional information below (Ex: TWICE discount code, special shipping instructions, purchase order number).

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