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~~ Happy 10th Birthday PCOSA ~~

PCOSA 2004 Fashion Show & Gala Registration Form

To Register for the Conference Click Here

!Important! Please read this before proceeding! There are 3 steps to registration:

Step 1 - General Information

Step 2 - Confirmation and Costs

Step 3 - Secure Payment through VeriSign

You must successfully complete all three steps in order to register for the conference! Upon completing Step 2, you will receive an email confirming your registration information and important details about making your travel arrangements. Upon completing Step 3 you will get a 2nd email confirming your payment. You must get BOTH of the emails to be registered. If you do not receive both emails please email info@pcosupport.org or call 877-775-PCOS to ensure your registration was received.

Step 1 of 3

First Name:

Last Name:

Address:

City:

State: Zip:

Country:

Phone:

Fax:

E-mail:

2004 Fashion Show and Fundraising Gala

QTY

Item

Price

2004 Gala Tickets Only

$60.00

All Gala Ticket Sales are final, there will be no refunds. Tickets are available for pre-registered conference attendees at $65 per person on-site.

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A Special Thanks to Our 2004 Sponsers:

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