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Medical Education and Research Institute of Nevada - MERIN Learn about MERIN body donation program - Generations

Training Program Registration

Facilities

Please fill out the following form to begin the course registration process or contact a MERIN representative at:

Medical Education and Research Institute of Nevada
874 American Pacific
Suite #120
Henderson, NV 89014
702-933-5627
Email: facilitymanager@merinv.org

General Information

Contact Person:
Organization:
Billing Address:
City:
State
Zip:
Phone:
Fax:
E-Mail:
Date Requested:
 
Alternate Date:
 
Time Requested:
Set-Up Time Needed:

Course Information

Course Title:
Special Positioning:
Pre-Course CT/MRI:
Yes No
Specify Area:
Audio/Visual Needs:
A/V Person Needed:
Yes No
Power Tools Needed:
Type of Equipment Being Shipped In:
Ship Date:
 
Approx. Qty:
Approx. Time:

Meals and Lodging

Meals:
(Check all that apply)
Snacks Breakfast Lunch Dinner
Lodging:
Yes No
Transportation:
Yes No
Additional Notes