Board Gift Questionnaire

ISMRM likes to show its appreciation to our board members with a small gift at the annual meeting. Some members are unable to travel with additional items, so we offer this opportunity to have your gift shipped to your home after the meeting.

Please complete this form at your earliest opportunity so we can better plan our shipments to and from the meeting.

"*" indicates required fields

Name*

First Last

Email*

Please select one of the following.*

I would like to receive my gift at the Annual Meeting. I will take it home with me or ship it on my own.

I would like the Central Office to ship my gift directly to my home after the Annual Meeting. I understand I will not receive it at the meeting.

I decline my gift, whatever it may be. I understand that limited supplies mean I cannot change my mind at a later date.

Please confirm that you do not want your gift and understand that this cannot be undone later.*

I confirm that I decline my gift, whatever it may be, and I understand that I will not be able to change my mind about this later.

Your home shipping address*

This address must be able to accept parcel deliveries OR have parcels left outside. Please, no PO boxes.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your mobile phone number*

For the shipping company to contact you in case of delivery issues. Please include your country code!

Board Gift Questionnaire

Contact

Events

Key Links

Explore Our Site