UCSF Naffziger Surgical Society Day
Friday, May 11, 2018
Your Name: ____________________________________________
Dinner Guest Name: _____________________________________
Lunch: $15.00
Dinner: $115.00 for yourself or $215.00 with a dinner guest
Amount enclosed: Lunch Only __________ $15.00 Lunch & dinner: $____________
Please make your check payable to: “UCSF Naffziger Surgical Society”
Please print this form and mail it with your check to:
UCSF Naffziger Surgical Society
179 Canterbury Ave.
Daly City, CA 94015
For any questions please call : (650) 992-1387
