The
is
pleased to present
“Mammography Technologists CE Day”
We have 7 great lectures specific to Mammography
Technologists!
Dr. Beth Siroty-Smith,
are Crucial to
Your Practice of Breast Ultrasound: Dr.
Shawn Conwell,
Pitts Radiology,
Dr. Paul Guerry, Pathology Department,
Palmetto Health Baptist,
Dr. Ram Kalus, Plastic
Surgery of the
ALALA: A Unique Boutique for
Today’s Surviving Woman, Cola, SC
Paula Griffin, BS, (R)(M) & Patricia Johns, RT(R)(M), Hologic,
Inc.
Mammographer to
Breast Cancer Survivor”
Tiffany Winslow, RN-Nurse Navigator &
Wendy Duheme, RT(R)(M)
Palmetto Health Baptist- Women’s Place,
Columbia, SC
“Seven Category “A” credits will be
applied for through ASRT”. This has
also been submitted for approval to SCRQSA.
REGISTRATION
FORM
“Mammography Technologist CE Day”
Hurry Spaces Are Limited and the Date is very soon!
SCSRT “RT(M) Day” is
Palmetto Health Baptist- Women’s Place
Parking available in attached garage
Name:_________________________________________
Credentials:__________________ ASRT #___________
Or SCRQSA # _____________________
Address:______________________________________________________________________________________
Email:_________________________________________
(Print clearly as this will be your
confirmation)
Phone: #:______________________________________
REGISTRATION is set up for
this day only. This form must accompany each person attending the conference. Full payment must accompany each registration. Advance
registration must be post marked by January 20, 2010. Registration received after January 20th will be charged a
LATE registration fee of an additional $50.00.
NO EXCEPTIONS
SCSRT CONFERENCE FEES: DAILY REGISTRATION FEES INCLUDE BREAKS, MEALS
AND LECTURES.
MEMBERS:
Technologist must enclose a copy of the SCSRT membership card, NO EXCEPTIONS.
NON-
MEMBERS: To take advantage of the discounted SCSRT member
fees, become a Society Member. The SCSRT
Application for Membership can be found on the website-www.scsrt.org and should
be submitted along with the registration packet.
CIRCLE the amount below and
enter this to the right. Then enter the
total amount enclosed below:
REGISTRATION FEE Date:
MEMBER $75.00
NEW MEMBER $75.00 + $35.00 New Membership
NON MEMBER $135.00
Late or Onsite: $75.00 (if a member) or $ 135.00
(non-member)+
$50.00
Total Enclosed
$______________
Please
make checks payable to “SCSRT- Continuing Education”.
Checks returned for Non –
Sufficient funds will be assessed the cost of the Conference plus a $50.00 fee.
Refund Policy: A
request for a refund must be made in writing and mailed to Millie Massey, SCSRT
Board Chair,
Registration can be
transferred to another Technologist with the same member status and payment
amount.
MAIL
to: Millie Massey
Phone: C:
803-240-5784
Home: 803-532-7331
Email: Masseym@midlandstech.edu
The SCSRT cannot guarantee
that all the lectures will be held at the published time(s) or by the published
speaker. The SCSRT reserves the right to
contact the ASRT/ARRT to withhold credit for any returned checks, until the
attendee is once again a member in good standing.
Minimum
number or participants needed to host the day:
12
PLEASE COPY THIS FORM BEFORE YOU MAIL IT FOR YOUR RECORDS !!
Directions to Palmetto Health Baptist-
Women’s
Place-
Take I-26 into
IF you get lost, call Millie Massey at
803-240-5784.