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HWSS Event Vendors Registration Form 

Primary Contact:  

Representative (s) attending:  

Exhibit fee:  

Payment Total ($)

By signing this form, I hearby acknowledge my compliance with the rules and regulations of the organization, including cleanliness and maintenace of my surroundings as well as the permises and our conduct towards others. 
I understand that I shall be liable for my own liability insurance and the organization shall not be responsible for any damage, injuries, cost, or death to our person or property that may be incurred during our use of the organization's facilities. 

 Harwell Wilson Surgical Society is a 501 (c)(3) non-profit organization. Our Tax Identification Number is 62-1587804

Thanks for your support!

Contact

Phone

(901) 448-3511

Email

Hours

Mon - Fri: 7am - 4pm

Address

The University of Tennessee Health Science Center
910 Madison Ave., 2nd Floor | Memphis, TN 38163

©2024 by UTHSC Department of Surgery. Proudly created with Wix.com

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