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2012 ACCA Cardiovascular Administrators’ Leadership Conference

2012 ACCA Cardiovascular Administrators’ Leadership Conference

To Register, you may either:

  • Call our offices directly at 847-759-8601
  • Mail or Fax 847-480-9282 in a Registration form
  • Complete the online registration form below

Entry Instructions: Use tab key or click box to advance to next question.
DO NOT USE “ENTER” KEY UNTIL READY TO SUBMIT FORM.

If you need to inquire about a previously submitted registration, please email registration department; do not submit another registration form

Your conference badge will reflect the information filled in below.

Required fields are in red

Email:
Name:
If Federal Sector:     Rank        Branch  
Designations:  
Badge Name:
Title:
Company:
Address:
              
City:     State:   Zip:    
Country: 
Phone:   Fax:

New Address?:    

*Please note: a selection must be made in each section for the form to be processed

ACCA Pre-Conferences  (Attend both and save $50) (Wednesday, March 21)

               Yes,  $320     Yes Non-Member,   $350   No, thank you, not attending both Pre-conferences

AM ACCA Pre-Conference  (Wednesday, March 21, 8:30 am – 12:00 pm)

               Yes,  $185      Yes Non-Member,   $200    No, thank you, not attending AM Pre-conference
                  

PM ACCA Pre-Conference   (Wednesday, March 21, 1:30 pm – 5:00 pm)
 
              Yes,   $185    Yes Non-Member,   $200    No, thank you, not attending PM Pre-conference

Full Conference Registration
includes reception, Thursday lunch, continental breakfasts and Thursday-Friday concurrent sessions
             Member,   $550
            Non Member, $735
                          Non Members who register for the full conference
                          are entitled to complimentary 2012 AAMA membership
                          (Registrants may not have been a member since 2008)
             Full-time Student (ID required), Member $150  
             Full-time Student (ID required), Non-Member $200  
             Not attending Full Conference

Customized Conference Registration

             Thursday only
            Member, $450         
            Non Member,  $485    
            Not Applicable

             Friday only
            Member,  $250    
            Non-member, $280    
            Not Applicable

Guest     
includes reception, Thursday luncheon & continental breakfasts
            Yes, $95   Not applicable 
Guest Name:

AAMA Members conveniently renew your membership NOW!
          Yes, Renew Now $230      No, thank you  
CAAMA EXAM (Wednesday, March 21, 1:00 – 5:00 pm) 
Advance Registration and Payment Required, registration Deadline is March 1, 2012
          Yes,  $250    Not Applicable 

Voluntary tax deductible donation to the AAMA Research & Educational Foundation:
Support excellence in healthcare administration  

The AAMA Foundation is exempt from taxation under section 501(c)3 of the Internal Revenue Code (IRC). Generally, contributions are considered charitable under the IRC section 170 and tax deductible as provided by law. The Foundation is eligible for matching funds. 

Special Needs (ex. Dietary)         

ACCA/AAMA CANCELLATION POLICY
 Cancellations must be received in writing by February 20, 2012, to qualify for a refund. A $50 processing fee will be deducted. All no shows will be billed. After February 20, 2012, no refund will be provided. Occasionally changes in the conference may be made due to speaker availability, participant demand or unforeseen circumstances. While ACCA/AAMA will do everything possible to ensure participant satisfaction, AAMA’s liability is limited to the registration fee only.

Note: By registering for this event, registrants agree that any conference photographs that include them as attendees may be used in future AAMA comminucations or promotional materials.

Headquarters Hotel:  

Doubletree Hotel – Magnificent Mile
300 East Ohio Street
Chicago, IL 60611

General Phone: 312-787-6100
Reservation Phone: 800-222-8733

Select Payment Type:

Pay Now with Credit Card
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               City: 
               State:    2 letter code
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         Registrations are not considered finalized until paid in full.
                

Please remit to:

American Academy of Medical Administrators
701 Lee Street
Suite 600
Des Plaines, IL 60016

Fax: 847-480-9282