Giveaway Registration

The Free Lab Workshop Giveaway* at ASCPinsurance.org October 25, 2008 through January 25, 2009
The American Sociaty for Clinical Pathology wants to help you discover financial security with the NEW ASCP insurance benefits website!
The ASCPInsurance.org website is your source for insurance and financial products. It’s provided as a valuable benefit of your membership in the American Society for Clinical Pathology. We’re so excited about this new website—we want to celebrate. So we’re giving away Free Registrations to a Lab Workshop of your choice. Click here to learn more about the Lab Workshops. Once you complete the form below, you will be registered in the random drawing.
Register here to win FREE registration to an ASCP sponsored Lab Workshop of your choice All fields below are required unless otherwise stated. All personal information will be kept confidential, and will only be used to send you information about the ASCP Group Insurance Program. For a complete list of the rules, please click here.

MEMBERSHIP NUMBER: <optional>

DATE OF BIRTH: / / (mm/dd/yyyy)

NAME: Mr. Miss Mrs. Ms. Dr.

First: MI: Last:

ADDRESS:

Street:

City:

State:

Zip:

E-MAIL ADDRESS:
A valid email address includes a user name and computer name, for example user@service.com.

HOME PHONE :

WORK PHONE :

*NO PURCHASE NECESSARY. A PURCHASE WILL NOT INCREASE YOUR CHANCES OF WINNING. LEGAL RESIDENTS OF THE 50 UNITED STATES (D.C.) 18 YEARS OR OLDER. VOID WHERE PROHIBITED. Sweepstakes ends January 25, 2009. For Official Rules and prize description visit Giveaway Rules.