2018 CNS ANNUAL MEETING Advance Registration and Housing Form OCTOBER 6 10, 2018 HOUSTON, TEXAS

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1 1 Advance Registration Deadline: September 6, 2018 All meeting confirmations will be sent via . REGISTRANT INFORMATION (Please type or print legibly using one form per person.) FIRST/GIVEN NAME LAST NAME CREDENTIALS BADGE NAME (as you would like it to appear on your badge) INSTITUTION/HOSPITAL/OFFICE/COMPANY NATIONAL PROVIDER IDENTIFIER (NPI) NUMBER MAILING ADDRESS CITY STATE/PROVINCE COUNTRY ZIP/POSTAL CODE TELEPHONE (If international please include country code) FAX European Union s General Data Protection Regulation (GDPR) Requirements: m Check here if you agree that the CNS can retain this information for the purposes of communication and service support set out in the CNS Privacy Policy. To view the Privacy Policy please visit Exhibitor /Phone Opt-out: m Check here if you do not want your phone number encoded. m Check here if you do not want your address encoded. Americans with Disabilities Act: m Check here if you require special accommodations or services in order to attend. You will be contacted by a CNS representative. Special Dietary Restrictions: m Vegetarian m Kosher (Please Specify) m None DEMOGRAPHIC INFORMATION Please help us collect accurate attendee demographics by answering the following questions. This information is required in order to process your registration. Please indicate your practice setting: (check one only) m Private m Full-time Academic m Private (Academic Affiliate or Appointment) REGISTRATION CNS MEMBER MEDICAL REGISTRANT Please indicate your subspecialty: (check all that apply) m Cerebrovascular m Peripheral Nerves m Endovascular m Skull Base Lesions m Epilepsy m Spine m Movement Disorders m Trauma m Pain m Tumor m Pediatric m Active (Domestic) $ 750 $ 950 m International $ 750 $ 950 m Associate $ 750 $ 950 m Active Duty Military $ 0 $ 0 m Armed Forces (Guard/Reserve/Retiree) $ 475 $ 675 m Transitional $ 750 $ 950 m Resident (Domestic) $ 150 $ 250 m International Vista Resident $ 150 $ 250 m Fellow (Domestic & Int l.) $ 200 $ 300 m Senior $ 450 $ 650 m Medical Student $ 0 $ 200 m Affiliate $ 350 $ 550 Please indicate your professional level: (check one only) m Director/Department Head Senior Management m Staff m Resident m Nurse/Nurse Practitioner/PA NON-MEMBER MEDICAL REGISTRANT Gender: (optional) m Male m Female Age: (optional) m Under 35 m m m m 66+ m Neurosurgeon $ 1000 $ 1200 m Physician (MD, DO, etc.) $ 1000 $ 1200 m Non-Physician $ 1000 $ 1200 (Clinical Researcher/Scientist)* m Neurosurgeon (Faculty) $ 850 $ 1050 m Resident** $ 400 $ 500 m Fellow*** $ 450 $ 550 m Medical Student $ 250 $ 450 m PA/Physician Extender $ 600 $ 800 m Nurse $ 600 $ 800 m Nurse Practitioner $ 600 $ 800 m Corporate Representative $ 1250 $ 1450 m ANSPA Member $ 575 $ 675 Non-Member categories ore open to domestic and international registrants. * Non-member/Non-physician category is limited to scientists, engineers, etc. involved in neurological research, and/or product development not affiliated with an exhibiting company. *All non-member Residents must have their Program Director sign registration form. If registering online, a letter from your Program Director certifying that you are a Resident in a neurosurgical training program must be faxed to , or ed to cns@mcievents.com within one week of completing registration. **All non-member Fellows must provide a letter from their Chief of Service verifying Fellow status within one week of completing registration, it may be faxed to , or ed to cns@mcievents.com. Corporate representatives attend for education only. They must not conduct sales activities in the meeting space, nor influence content in any way. Solicitation of medical attendees is strictly prohibited. lncludes one year of CNS Affiliate membership in 2019 for ASPNA members only. PROGRAM DIRECTOR (PRINT OR TYPE NAME) PROGRAM DIRECTOR SIGNATURE m YES! I am interested in volunteering for the CNS Sergeant-at-Arms Committee. (Valid for residents and fellows only.) NON-MEDICAL REGISTRATION m Spouse/Guest/Child 13 & Over $ 150 $ 250 m Spouse/Guest/Child 13 & Over $ 75 $ 150 (Resident/Fellow) m Child (12 & Under) $ 0 $ 0 SPOUSE/GUEST FULL NAME SPOUSE/GUEST FULL NAME SUBTOTAL REGISTRATION $

2 2 HOTEL ROOM RATES Single/Double Room Rate Only m Marriott Marquis Houston Headquarters Hotel m $ 269 $ m Embassy Suites by Hilton Houston Downtown m $ 239 $ m Four Seasons Hotel Houston m $ 305 $ ** m Hampton Inn Houston Downtown m $ 239 $ m Hilton Americas Houston m $ 269 $ m Homewood Suites by Hilton Houston Downtown m $ 239 $ m Westin Houston Downtown m $ 219 $ Room Rate with local/state tax and fees* *Tax rates subject to change. **An additional State Cost-Recovery Fee of $2.25 will be charged per room per night. The fee will be included in the one night room and tax deposit. HOTEL RESERVATIONS Special Requests m Two (2) Beds SEPTEMBER/OCTOBER 2018 m Crib (additional fee may apply) m Rollaway bed (additional fee may apply) S M T W T F S ARRIVAL DATE DEPARTURE DATE Please note, CNS cannot guarantee bed type or special requests as this is subject to availability upon arrival at the hotel. If your preferred hotel choice is not available, you will be contacted and confirmed into the next available hotel. m Please check this box if you are interested in reserving a suite. (A CNS housing center representative will contact you regarding suite availability and rates. In the meantime, a standard room will be assigned.) HOTEL CHANGE/CANCELLATION POLICY Please Note: Each hotel has its own cancellation policy and some may charge an early departure fee. The individual hotel s policies will be listed in your confirmation. Any cancellations not made within the hotel s cancellation policy will result in forfeiture of your one night s room and tax deposit. The deadline date for new reservations based on availability is September 25, The hotel requires a deposit of one night s room and tax to reserve your room. Please continue to make any requests/changes by ing cns@mcievents.com or calling through September 25, Beginning September 26, 2018, changes and cancellations must be made with your assigned hotel. SUBTOTAL HOTEL DEPOSIT $ If not registering for optional courses, skip to page 5 for payment.

3 3 CNS Annual Meeting registration is required in order to purchase optional course tickets Register early to receive your preferred choice All meeting confirmations will be sent via 1 REGISTRANT INFORMATION (Please type or print neatly in black ink.) FIRST NAME LAST NAME COURSE DIRECTORS/FACULTY/MODERATORS: No one-day speaker badges will be issued. Full meeting registration fees apply from page 1. However, there will be no fee assessed for the course(s) in which you are participating. Please check the faculty box next to your course selection below. Please check one: m Physician m Nurse/NP/PA m Resident/Med Student 2 SYMPOSIA Saturday, October 6, 2018 Sunday, October 7, 2018 FEE: $300 Physician $200 Nurse/NP/PA $100 Resident/Med Student m SYM1 Neurovascular Update: Evidence-based Guidelines in Ischemic and Hemorrhagic Stroke for the Practicing Neurosurgeon FEE: $300 Physician $200 Nurse/NP/PA $100 Resident/Med Student m SYM2 Robotics Symposium SUBTOTAL SYMPOSIA $ 3 PRACTICAL COURSES Saturday, October 6, 2018 FEE: $650 Physician $425 Nurse/NP/PA $175 Resident/Med Student m PC01 Severe TBI update: Trends and Tools* MORNING 8:00 AM 11:30 AM m PC02 Minimally Invasive Spine Surgery Case-based Complications and Future Directions m PC03 Cervical Spine Case Management: Techniques and Technology Update m PC04 Bypass Techniques in Cerebrovascular Neurosurgery m PC05 Endoscopic Craniosynostosis Repair: Hands on Course m PC06 Update on Movement Disorders: Case Based Review of Approaches and Controversies m PC07 Modern Applications of Radiosurgery m PC08 WINS Practical Course on Leadership and Education m PC09 3D Surgical Neuroanatomy (Supratentorial) AFTERNOON 12:30 PM 4:00 PM m PC10 m PC11 m PC12 m PC13 m PC14 Innovation, Quality and Safety A Balance Along the Continuum of Care for Neurosurgical Patients Spinal Trauma and Spinal Cord Injury: Case-based Presentations and Future Directions* My Worst Spinal Complication: What I Learned Peripheral Nerve Surgery: Techniques and Exposure 3D Surgical Neuroanatomy (Infratentorial) m PC15 Neurosurgeon-hospital Relationships: Options, Negotiations, and Achieving What You Are Worth Sunday, October 7, 2018 FEE: Complimentary m PC16 Association of Neurosurgical Physician Assistants (ANSPA) Fall 2018 CME Meeting Presented in Collaboration with Congress of Neurological Surgeons (CNS) MORNING 8:00 AM 11:30 AM m PC17 m PC18 m PC19 m PC20 m PC21 m PC22 m PC23 m PC24 New Era in Stenting CPT Update Spinal Biomechanics in Modern Clinical Practice Thoracolumbar Spinal Deformity for the Non-Deformity Spine Surgeon Neurosurgical Treatment of Chronic Headache Review of Functional Neurosurgery for the Non-Specialist* Surgical Management of Eloquent Area Tumors: Functional Mapping and/or Navigation Brain Tumor Update Part 1: Malignant Brain Tumors m PC25 Concussion Practical Course AFTERNOON 12:30 PM 4:00 PM m PC26 Big Data Core Principles of Data Science for Neurosurgeons FEE: $000 Physician $000 Nurse/NP/PA $000 Resident/Med Student m PC27 Surgical Strategies and Techniques for Carotid Stenosis: CEA and Stenting m PC28 Brain Tumor Update Part 2: Benign Brain Tumors SUBTOTAL PRACTICAL COURSES $ See page 5 for complete payment information

4 CNS ANNUAL MEETING 4 LUNCHEON SEMINARS Cost per Luncheon Seminar: $95. Discounted pricing of $75 offered for residents/fellows/medical students/advance practice providers. Ticket price will be applied based on your membership/registration status. MONDAY, OCTOBER 8, :15 1:45 PM TUESDAY, OCTOBER 9, :15 1:45 PM WEDNESDAY, OCTOBER 10, :15 1:45 PM m M01 m M02 m M03 m M04 m M05 m M06 m M07 m M08 m M09 m M10 m M11 Honored Guest Lunch: The Business of Medicine in the 21st Century: Pearls and Pitfalls (Complimentary to CNS Resident members) Navigating MACRA/MIPS and Bundled Payments Is Intracerebral Hemorrhage a Surgical Disease? Venous Stenting for Pseudotumor Controversies in Spinal Deformity Surgery Cervical Spondylotic Myelopathy: Anterior Versus Posterior Approaches* Management of Chronic Subdural Hematoma Management of Brachial Plexus Injuries: from Birth to Adult Key Clinical Trials in Epilepsy Surgery Update on Diagnosis and Management of Low Grade Gliomas Acoustic Neuromas: Current Management Strategies* m T12 Medical Malpractice Update 2018 m T13 m T14 m T15 m T16 m T17 m T18 m T19 m T20 m T21 m T22 Dural AV Fistula: Diagnosis, Classification, and Management Update on the Management of Anticoagulation and Anti-platelet Therapies in Neurosurgical Patients Spinal Tumor Surgery: Case Based Management Peak Performance: Optimizing the Spine Surgical Patient from Preop to Postop Combat and Mass-Casualties: Neurosurgery Under Fire SCS: Evidence and Applications Pediatric Dystonia: Advancements with DBS and Management Updates Malignant Gliomas: Advances in Surgery and Adjuvant Therapy* Management of Pituitary Adenomas and other Sellar Pathology Diversity in Learning: New Initiatives in Mentorship m W23 m W24 m W25 m W26 m W27 m W28 m W29 m W30 m W31 Spinal Arteriovenous Fistulae and Malformations: Management Strategies in 2018 Contemporary and Practical Management of an Enigmatic Process: Cerebral Vasospasm (Delayed Cerebral Ischemia) Novel Techniques for Management of Lumbar Spondylolisthesis Peripheral Nerve Entrapment Syndromes: Diagnosis and Management* Sports-related Injuries Pediatric Head Trauma Cutting Edge management of Brain Metastasis Advanced Imaging of Brain Tumors Enhancing Communication Skills to Lead Your Practice *SANS Supplemental Exam is available for purchase with the course for an additional $15. SANS Supplemental Exams may also be purchased separately without having to attend the live course (see page 5). SUBTOTAL LUNCHEON SEMINARS $ 5 DINNER SEMINARS Cost per Dinner Seminar: $190 SATURDAY, OCTOBER 6, :30 8:30 PM MONDAY, OCTOBER 8, :30 9:30 PM TUESDAY, OCTOBER 9, :30 9:30 PM m DIN1 The Bottom Line in a Changing World Updates about CPT, ICD-10, MIPS and Bundling m DIN2 m DIN3 Advances and Controversies in Intracranial AVM Management Robotics and Spinal Surgery: The Future is Now m DIN4 Emerging Indications for Functional Neurosurgery: Tourette, OCD, Depression and Pain SUBTOTAL DINNERS SEMINARS $

5 CNS ANNUAL MEETING Continue your education after the Annual Meeting and earn one hour of additional CME credit with SANS Supplemental Exams! The supplemental exams for each of the following courses are available for only $15 each. Any Annual Meeting attendee can purchase these exams, regardless of attendance at the live courses. 6 SANS SUPPLEMENTAL EXAMS m PC01 SANS Severe TBI update: Trends and Tools $ 15 m PC11 SANS Spinal Trauma and Spinal Cord Injury: Case-based Presentations and Future Directions $ 15 m PC22 SANS Review of Functional Neurosurgery for the Non-Specialist $ 15 m M06 SANS Cervical Spondylotic Myelopathy: Anterior Versus Posterior Approaches $ 15 m M11 SANS Acoustic Neuromas: Current Management Strategies $ 15 m T20 SANS Malignant Gliomas: Advances in Surgery and Adjuvant Therapy $ 15 m W26 SANS Peripheral Nerve Entrapment Syndromes: Diagnosis and Management $ 15 SUBTOTAL SANS EXAMS $ 7 PAYMENT Subtotal Registration $ Subtotal Hotel Deposit $ Subtotal Symposia $ Subtotal Practical Courses $ Subtotal Luncheon Seminars $ Subtotal Dinner Seminars $ Subtotal SANS Exams $ TOTAL $ m Check: Full payment must accompany your registration form. Make check (US Dollars drawn on a US Bank) payable to: CNS Annual Meeting Registration and Housing Center, 6100 W. Plano Pkwy, Suite 3500, Plano, TX (Any checks received from an overseas bank will be returned. Any checks returned for insufficient funds are subject to additional charges.) m Credit Card Authorization: Credit card will be charged immediately for registration fees. (US dollars drawn on a US bank) m Visa m American Express m MasterCard CREDIT CARD NUMBER NAME OF CARDHOLDER (PRINT) BILLING ADDRESS (IF DIFFERENT THAN REGISTRANT) SIGNATURE EXPIRATION DATE (MONTH/YEAR) By signing this form: I authorize the CNS Registration and Housing Center to charge my credit card for the total payment due, acknowledge that the CNS registration cancellation policies are in effect, and grant the CNS the right to use photos taken at the CNS Annual Meeting which include me in promotional materials for future meetings. These fees are subject to audit and in case of error, the CNS Registration and Housing Center reserves the right to correct the error and charge the appropriate fees. Registration Cancellation Policy: Full registration refunds, less a $100 processing fee, will be granted if written requests for cancellation are received by 5:00 pm CT on September 13, Course, seminar, and event tickets will be refunded in full until September 13, No refunds of any kind will be given after this date, regardless of cause. Refunds will not be given for no-shows. Any changes to existing badges after the published cut-off date of September 13, 2018, are assessed a $50 processing fee. Written requests may be ed to cns@mcievents.com, faxed to , or mailed to the CNS Annual Meeting Registration and Housing Center, 6100 W. Plano Pkwy, Suite 3500, Plano, TX RETURN TO CNS REGISTRATION AND HOUSING CENTER You may also register online at Fax: (credit card only) Mail: CNS Annual Meeting CNS Registration and Housing Center 6100 W. Plano Pkwy, Suite 3500 Plano, TX 75093