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Nesbit Registration Form
September 7-10, 2023
University of Michigan Department of Urology, 1500 E. Medical Center Dr, 3875 Taubman Center, SPC 5330, Ann Arbor, MI 48109-5330
Phone: (734) 764-5502
Fax: (734) 763-2572
Email:
SupportNesbit@umich.edu
Registration confirmation will be sent by email
For more information on the Nesbit Society Meeting go to
Department Website for Nesbit Events
Select Events than select Nesbit Visiting Professors for more information.
Hotel Booking Links for Fall Nesbit
Hilton Garden
Hampton Inn
Kensington Hotel
EVEN HOTEL
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* Indicates required question
Registration due by August 1, 2023
Year Inducted into Nesbit
Your answer
Name
*
Your answer
Email Address
*
Your answer
Institution/Company
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Guest Name
Your answer
Food Allergies
*
Your answer
Food Allergies for Guest
*
Your answer
Which hotel did you choose for your visit? We will
ONLY
be providing transportation from the hotels linked above
Hilton Garden
Hampton Inn South
Kensington/EVEN
Do you need transportation to Nesbit Events?
*
Yes
No
Transportation from
Hotel(s)
to
Events
*
Yes
No
Thursday, Nesbit Welcome and Grand Rounds 5:30pm-7:00pm
Friday, Nesbit Society Meeting with Visiting Professors at NCRC 7:30am-4:00pm
Friday, Greyline Dinner 6:00pm-8:00pm
Saturday, Tailgate and Game Time: TBA Michigan vs UNLV
Yes
No
Thursday, Nesbit Welcome and Grand Rounds 5:30pm-7:00pm
Friday, Nesbit Society Meeting with Visiting Professors at NCRC 7:30am-4:00pm
Friday, Greyline Dinner 6:00pm-8:00pm
Saturday, Tailgate and Game Time: TBA Michigan vs UNLV
Transportation from
Event(s)
back to
Hotel
*
Yes
No
Thursday, Grand Rounds NCRC
Friday, Nesbit Society Meeting
Friday, Greyline Dinner
Saturday, Pick up after Tailgate ONLY
Saturday, Pick up after game
Yes
No
Thursday, Grand Rounds NCRC
Friday, Nesbit Society Meeting
Friday, Greyline Dinner
Saturday, Pick up after Tailgate ONLY
Saturday, Pick up after game
# Attending
Thursday, September 7
(Welcome Reception/Urology Grand Rounds Conference Visiting Professor Dr. Stephen Nakada - 5:30-7:00 PM)
*
Your answer
# Attending
Friday, September 8
(Nesbit Visiting Professor Program NCRC 2800 Plymouth Road Building 18 - 7:30 AM-4:00 PM)
*
Your answer
# Attending
Friday, September 8
(Dinner at Greyline 5:30 pm 100 N Ashley Ann Arbor MI 48104) $100 per guest
*
Your answer
Please call Brittany Smith at 734-764-5502 to pay by credit card.
Your answer
# Attending
Saturday, September 9
(Tailgate, you and a guest or family are welcome) Time TBD, 309 Berkley
*
Your answer
Tailgate Guest/Family Member Names and Children's Ages
Your answer
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