NEROC Registration Name (with credentials) *Medical School:AOA #Year of GraduationName for Badge *Contact InformationStreet Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeEmail Address *Phone *Area of PracticeRegistration Type(Check one)REGISTER TODAY!!! RESERVE YOUR SPOT AND JOIN US! Physician EARLY BIRD REGISTRATION FEE – $295.00Resident Registration Fee – $100.00Registration TotalsRegistration FeePrice$Cancellation Policy: Requests for cancellation refunds must be postmarked by September 1, 2025. After that, NEROC will issue credit. Credit / Debit Card *RegisterPlease do not fill in this field.