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REGIS TR ATION FORM l stsa 2015 L A K E B U E N A V ISTA FL O R ID A Southern Thoracic Surgical Association 62nd Annual Meeting Disney s Yacht Beach Club Resorts Lake Buena Vista FL November 4 7 2015 www. Each member of your party must have a ticket to enter to the President s Mixer. Small children will be allowed to enter with a ticket-holding adult. 25 per person TOTAL AMOUNT DUE CHECK MasterCard American Express CARDHOLDER NAME AND BILLING ADDRESS EXP. Stsa.org All names should be printed...
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