Online Registration

Title of course
Date of course
Name
Address
City
State
Zip
Specialty
Name of practice
Phone
Fax
E-mail
Course registration fee
$
Type of card
 Visa
Discover
Mastercard
American Express
Complete name on card
Number on card
Expiration date
Comments/Questions/Additional Notes

Prefer to register my mail or fax? Click here to download a printable registration form.

For more information, contact April Batten at MSMS at 517-336-5784 abatten@msms.org.