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AAOP CALENDAR
NO EVENTS FOR THIS MONTH
ONLINE REGISTRATION FORM
Annual Scientific Summer Meeting
Midwest Chapter AAOP
June 11-13, 2009
Please register before June 1, 2009 to avoid late fees
Each full registration includes: Member's registration, continental breakfast and lunch on Friday and Saturday and supplier cocktail party on Friday.

Name:
Company:
Address:
Phone:
City:
State/Zip:
    
E-Mail:
Fax:
Certificate type and number:
Fees: (check all that apply)
Early Reg.
Late reg.
Midwest Chapter AAOP Member
$175.00
$225.00
Eligible Non-member and BOC
$225.00
$275.00
Allied Health Professional
$175.00
$225.00
Techinicians, Students, and Emeritus
$100.00
$125.00
Single Day Registration: (includes lunch)
Please Indicate:
Friday
Saturday
Midwest Chapter AAOP Member
$100.00
$125.00
Eligible Non-member and BOC
$125.00
$150.00
Techinicians, Students, and Emeritus
$75.00
$100.00
Click here to add additional registrants
Single Day Registration: (includes lunch)
Please Indicate:
Friday
Saturday
Midwest Chapter AAOP Member
$100.00
$125.00
Eligible Non-member and BOC
$125.00
$150.00
Techinicians, Students, and Emeritus
$75.00
$100.00
Click here to add additional registrants
Single Day Registration: (includes lunch)
Please Indicate:
Friday
Saturday
Midwest Chapter AAOP Member
$100.00
$125.00
Eligible Non-member and BOC
$125.00
$150.00
Techinicians, Students, and Emeritus
$75.00
$100.00

If you have a foursome arranged please contact Jason Tamalunas at (269) 983-6118
or email him at jasont@americanlimb.com. We will attempt to accommodate foursomes and twosomes as requests are made. Please include fee for golf outing with registration.

Golf Outing
$175.00
 
Active Member Fee
$35.00
 
Special Requirements:
 

Total Registration Fees:
   

** Three weeks notice for cancellation to recieve partial refund.
Notice: You will be redirected to PayPal.com for payment processing. You may use a credit card by scrolling down on the PayPal site to the “Don’t have a PayPal Account” Section of the PayPal Website.

 

 


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