1. Attendee Information
First Name Last Name Credentials
Institution Department Position or Title
Phone Number Email
2. Payment Information & Instructions
Please select payment type and follow the specific instructions below.
CTO Staff Member (Adult CTO): Payment for Cancer Center CTO staff members is processed automatically via internal transfer. No further action is needed. Please click the submit button below to complete registration.
Internal Transfer, Other MCW Staff: If you are paying by internal transfer a number must be provided. This is a Cost Center, Natural Account, Fund or Grant Number. The transfer will be $25 to the MCW Cancer Center Clinical Trials Office. Registration will be complete upon approved and completed transfer of funds. The Department Administrator or Business Manager will be e-mailed and asked to confirm that payment for this course has been approved. Internal transfers occur from MCW departments. Remember, a NUMBER MUST be provided as only MCW departments can initiate an internal transfer of funds.
Please enter an account number to be debited:
Name of Department Administrator or Business Manager
email of Department Administrator or Business Manager
Check Payment: If paying by check, please send a $25 check, payable to the MCW Cancer Center, to Paulette Jacobs, Clinical Trials Office, Clinical Cancer Center, 8701 Watertown Plank Road, Milwaukee, WI, 53226. Registration will be complete upon receipt of check.
3. Complete Registration Form by Clicking the 'Submit' Button Below
Registration deadline is September 26th. Seating is limited to the first 75 paid registrants. Please contact Paulette Jacobs with any questions at 414-805-4594 or firstname.lastname@example.org.