Join/Donate YES! I want to participate in PSR's workto protect human health and the environment. Contact InformationPrefixNoneDr.Mr.Mrs.Ms.MissFirst Name *Last Name *SuffixStreet AddressApartment, suite, etcCityStateZIPCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePhoneEmail Address *MembershipNone - Donation and/or dinner payment onlySponsoring Member (Physicians & other health professionals w/ doctoral degrees) - $125Supporting Member (Residents, Interns, Nurses, other health professionals, concerned citizens) - $50Retired Member - $35Student - $10DonationGeneral Donation AmountDirected Scholarship Fund Donation AmountAnnual Dinner ReservationsMake reservations for the annual dinner hosted jointly by Americans Against Gun Violence and PSR/Sacramento, featuring a keynote address by Dr. Michael North of Scotland entitled, "Gun Control in Great Britain after the 1996 Dunblane Primary School Mass Shooting: A Model for the USA." Date: Saturday, October 21Time: Check-in and Social Hour 6-7 PM; Dinner and Program 7-9:30 PMPlace: Hilton Arden West, 2200 Harvard Street, SacramentoCost per person: $60 Please enter your first and last name in the fields under 'Contact Information,' above, before proceeding to make your dinner reservation(s).Number of Reservations ($60 per person):Name(s) of person(s) for whom you're making reservations and entrée choices (salmon, chicken or vegetarian). Include your own name and any titles, degrees, etc., that you'd like included on name badge(s)Payment MethodPSR/Sacramento is a 501(c)(3) non-profit organization. Membership payments and donations are tax-deductible. Dinner/Lunch payments are not tax-deductible.I will submit payment *by sending a check to PSR Sacramentowith a secure credit card paymentCalculationsYou cannot pay by credit card if the total is $0 or less. Either select a membership, enter a donation, or register for dinner.Pay by check