• Download Registration Form 
*
Mail Registration Form with check enclosed to:
U.S. – Thai Pharmacy Consortium
ATTN: Gloria Eichenseher
The Pyle Center, Rm. 139
702 Langdon Street
Madison, WI 53706
OR Fax form with credit card or
purchase order information to:
(608) 265-3163
*You will need Acrobat Reader 7 or higher to fill this form out within Acrobat.