Tri Cities Pain Conference Registration Form 26: Submission #1481
The Table page displays a submission's general information and data using tabular layout. Watch video
Submission information
Submission Number: 1481
Submission ID: 3954
Submission UUID: e6d75545-0fbb-408a-81b5-82d9c125b585
Submission URI: /tripain26/form
Created: Tue, 12/02/2025 - 00:58
Completed: Tue, 12/02/2025 - 00:59
Changed: Tue, 12/02/2025 - 01:00
Remote IP address: 192.88.134.7
Submitted by: russ4031
Language: English
Is draft: No
Current page: Complete
Webform: Paid/Free Conference Registration
Submitted to: Tri Cities Pain Conference Registration Form 26
| First Name | Grace |
|---|---|
| Last Name | McNelly |
| mcnellyeliza@gmail.com | |
| Degree | M.D. |
| Specialty | d |
| Clinic/Organization | |
| Conference Format | |
| Address | |
| City | |
| State | |
| Zip | |
| Phone | 3 |
| Payment | Check |
| Conference type | Complete Conference |
| Thursday | |
| Friday | In Person |
| Saturday | Recording |
| Notes | |
| anet_transaction_reference | ref1764637154 |
| anet_payment_status | success |
| Ammount | 433.26 |
| Registration code | tripain26 |
| Title | Tri Cities Pain Conference 26 |
| Receipt | Receipt |
| Payment Note | RussoCME 935 SE High St Pullman, WA 99163 |
| Invoice number | tripain26_1764637129 |
| Tax | 18.26 |
| Base amount | 415 |
| Taxed Amount | 207.5 |
| Total Days | 2 |
| Recording Days | 1 |
| Non Recording Days | 1 |
| Per Day Amount | 207.5 |
| Tax Percentage | 8.8 |