The Encore at Wynn Las Vegas
Wednesday, September 10th , 2014 -
Saturday, September 13th , 2014
Wednesday: Arrival, Cocktail Party
Thursday: Breakfast, Meetings, Lunch, Reception & Dinner
Friday: Breakfast, Meetings, Lunch, Poolside Cocktail Reception
Saturday: Closing Breakfast
Please R.S.V.P Number of Guests to [email protected]
2014
Healthcare & Technology
Conference
Presenting Companies Include:
Sponsors Include:
AEGIS CAPITAL CORP. Member FINRA/SIPC
REGISTRATION FORM
Company Name: _______________________________________________ Contact Name: _______________________________________________ Address: _______________________________________________ _______________________________________________ Phone: _______________________________________________ Email: _______________________________________________ Industry: _______________________________________________
____________________________________________________ Please fill out the information below only if you would like to present at the Aegis Healthcare Conference. (Rate = $5,000) Payment by: Wire Instructions Bank: First Republic Bank 1230 Avenue of the Americas, 2nd Floor New York, NY 10020 Account Name Aegis Capital Corp. – Investment Banking Account ABA #: 321081669 Account Number: 80001862995 Swift Code: MLBTUS33FRB ____________________________________________________
Please print your name and sign below if you plan on attending. Print: ________________________________________ Signature: ________________________________________ Upon completion, please send registration form to [email protected]. Thank you!