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Tell us who you are? :
I am a Physician

Physician Registration Form

All fields marked with * are mandatory

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I want to support the event by buying Raffle Tickets:

Quizathon flier
2017Quizathon_FAQs.pdf (Quizathon FAQs )
2017Quizathon_LiabilityReleaseForm.pdf(Quizathon Liability Release form)
2017Quizathon_SampleQuestions.pdf (Quizathon Sample Questions)
Thank you for showing interest to buy raffle tickets to support the Quizathon Championship Trophy. All proceeds go towards supporting the Event Expenses. Please send an email to info@tahts.org. Please provide the following information when sending the email.

  1. First Name
  2. Last Name
  3. Middle Initial(optional)
  4. Email
  5. Telephone(where you can be reached at)
  6. No of Raffle Tickets you are intrested to purchase

Quizathon Championship Trophy Registration(November 5th, 2017@ 2PM)

(In order to meet the expenses there will be a nominal charge of $ 10.00 per student. Checks should be made in the name of TAHT)

Name of the Participant
Name of the Parent/Guardian:

Participant/Parent/Guardian Contact Email ID: