Hair Loss Summit

Summit Theme: "Help I am losing my hair, and I don't know what to do"...

Place: Embassy Suite Olympic Park

Location: Atlanta, GA.

Date & Time: Saturday, February 20th, 9:00 am

Guest Participation (check one) Doctor (What Type?) Health and Wellness (What Type?) Trichologist (How Long?) Beauty Professional (Title?) Beauty Product Company (Title?) Consumer Other
In the guest participation part 2 box below please answer the secondary question of the option you chose in the guest participation part 1.
Guest Participation Part 2

In the guest participation part 2 box below please answer the secondary question of the option you chose in the guest participation part 1.
Contact Information: (All information is REQUIRED)
Full Name First Last
Phone - (###) - ### ####
Cell Phone - (###) - ### ####
Business Name
Business Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
In a few words tell us your purpose in attending the Hair Loss Summit.
Registration Cost: $35, you will be transferred to a pay pal payment page. Please print receipt and bring to the summit.

Online registration closes February 12, 2010.

Special Note: walk up registration starts at 8:00 am and will be $45.00 on site

Hair Loss Summit

Hair Loss Summit

Contact Information: (All information is REQUIRED)

Registration Cost: $35, you will be transferred to a pay pal payment page. Please print receipt and bring to the summit. Online registration closes February 12, 2010. Special Note: walk up registration starts at 8:00 am and will be $45.00 on site

Registration Cost: $35, you will be transferred to a pay pal payment page. Please print receipt and bring to the summit.

Online registration closes February 12, 2010.

Special Note: walk up registration starts at 8:00 am and will be $45.00 on site