Washington State Conference Registration Form

Washington State Conference Registration Form

To Register, you may either:

• Call our offices directly at 847-759-8601
  
• Mail or Fax 847/759-8602 in your printed Registration form
  
• Complete the online registration form below.

  Use TAB or your mouse to advance to the next field.
  DO NOT HIT ENTER UNTIL READY TO SUBMIT THIS FORM.

  Your e-mail:
  Full Name:
  Badge name if different than first name:
  Title:
  Organization:
  Address 1:
  Address2:
  City:
  State:
  Zip Code:
  Phone:
  Fax:
  AAMA Members Is this a new address?		YesNo
  Payment Method:		CheckVISAMCAMEX
  Credit Card No.:
  Expiration date:
  You may mail your check or credit card information to the Academy office under separate cover. Payment may be made by check, Visa, Mastercard or American Express. Be sure to include expiration date and signature for credit card payments. Checks should be made payable to “AAMA”. Please remit to: American Academy of Medical Administrators 701 Lee St. Suite 600 Des Plaines, IL 60016
  FULL PROGRAM REGISTRATION FEES (April 19-20, 2001)
  AAMA  Member  (before 4/13/01)	$89.00
  All others, including on site registration	$99.00
  Full-Time Students with valid ID card	$40.00
  CAAMA EXAM April 20
  Exam Registration:	$250.00

  CANCELLATION POLICY
  Attendees may cancel their conference registration up to one-week in advance of the meeting(April 12, 2001) and receive a full refund minus a $25.00 administrative fee. Requests must be received in writing. After April 12, 2001, no refunds will be provided.No shows will be billed.

  EARLY REGISTRATION IS ENCOURAGED

© Copyright 2001 – American Academy of Medical Administrators