WISER DEI Symposium Registration Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *OrganizationComments or QuestionsWhich Session will you attend? *Online Morning - $50Onsite Afternoon - $75Both Morning and Afternoon - $100Do you have a coupon code? *Please Select OneYesNoCoupon CodeYour Discounted Price for the Morning SessionPrice: $ 40.00(20% Discount)Your Price for the Morning SessionPrice: $ 50.00Your Discounted Price for the Afternoon SessionPrice: $ 60.00(20% Discount)Your Price for the Afternoon SessionPrice: $ 75.00Your Discounted Price for Both SessionsPrice: $ 80.00(20% Discount)Your Price for Both SessionsPrice: $ 100.00Total$ 0.00Authorize.Net SSL Encrypted Payment Process *Card NumberMM123456789101112Expiration/YY2324252627282930313233Security CodeSubmit Education and Simulation Improving Healthcare 412-648-6073 wiserhelp@upmc.edu FollowFollowFollowFollow
