Manual Medicine Registration Form

CME Home page

PLEASE NOTE that this registration is contingent on:
- any required prerequisites.
- available class slots.
- clearance of payment.
- You will receive confirmation from our office when your registration is processed.

We are unable to take credit card payments by phone, fax, or email. Please use this secure online registration form to pay by credit card.

To pay by check, print out the registration form, and mail it along with a check made out to Michigan State University to:

MSU College of Osteopathic Medicine CME Office
965 Fee Road, Room A306
East Lansing, Michigan 48824

CANCELLATION POLICY: Registration fees will be refunded, minus a $200.00 administrative fee, with written notice (email or mail) 30 days prior to the start of the program.

Course Information

Course Title (Full Tuition/Early Bird Tuition)[Course dates]

Check this box if you have taken this course through MSU-COM previously:
Example: If you have attended Muscle Energy: Part I through MSUCOM and want to take it again, this will qualify as a repeat course.

Check this box if you are currently a resident:

Attendee Information

Attendee Name:

Address Type: Home Business

Address Line1:   

Address Line2:   

Attendee City:   

Attendee State:

          Country:   

                  Zip:   

             Phone:  

                 Fax:  

               Email: 


   (This is only for our records and will not be given to third parties.)

Please select a meal type:

Gluten Free Vegan Vegetarian
No Preference Other:

Please check one of following:

D.O. M.D. P.T. D.D.S.
Other:

Check to use Attendee Information into Billing Information:

Billing Information

    Billing Name:  

  Address Line1: 

  Address Line2: 

        Billing City:  

      Billing State:

          Country:   

          Billing Zip:

     Billing Phone: 

       Billing Email: 

Housing Information

The MSUCOM East Lansing courses housing arrangements can be made with TownePlace Suites

Towne Place Suites
2855 Hannah Blvd.,
East Lansing, MI 48823
Phone: 1-517-203-1000

The MSUCOM Nova SouthEastern University course housing arrangements can be made with Staybridge Suites

Staybridge Suites
Tampa East-Brandon
3624 N. Falkenburg Road
Tampa, FL 33619
Phone: 513-227-4000

Please contact the hotel directly for housing.