Conference Attendee Registration - All-Alaska Medical Conference


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Conference Attendee Registration

To register for the All-Alaska Medical Conference 2011, please fill out the form below. Required fields are marked with a red asterisk (*).

Alternatively, you may print this document and mail or fax it to us.

Note: Please register on or before September 23th. Registration cost increases after the 23th.

First Name:*

Last name:*

Professional Designation:

Practicing City/State:*

Speciality:

AAPA Member number:

Mailing address:*
(your CME certificate will be mailed here)

City:*

State:*

Zip:*

Phone:*

Fax:

Email:*

Registration fees:*

REGISTRATION FEES INCLUDE: CME, Continental Breakfast, Refreshment Breaks, Lunches and Annual Meeting/Dinner.

	Received by Sep. 23	After Sep. 23	On site
AKAPA Member:	$470	$520	$570
Non-Members (including NPs & MDs):	$555	$605	$625
Health Aides and Paramedics:	$320	$370	$395
PA Students:	$85	$100	$110
DAILY REGISTRATION:
AKAPA Members:	$185
Non-Members	$195

Please select the day(s) you will be attending:*

Monday
Tuesday
Wednesday
Thursday

The AKAPA Annual Meeting of the Membership will take place on Tuesday, October 4 at 5pm at the conference site. This meeting is only open to members of the AKAPA. If you would like to become a member of the AKAPA, please click here.

Will you be attending the Annual Membership Meeting?* Yes No

OPTIONAL BINDER:

Please check the box if you would like us to provide you a binder with all conference materials in printed format at the amount of $50.

Total Registration: (Select a registration option above)

Preferred method of payment:*

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Mail in check

Any additional comments:

Please type in the security code you see in the image:*

All-Alaska Medical Conference 2011
Monday, October 3 – Thursday, October 6
Sheraton Anchorage Hotel and Spa

Download printable registration