APMA News - February 2012 - (Page 59)

ADVANCE REGISTRATION n Scientific Program & Special Sessions Registrants will be provided with a final registration form which will include an opportunity to indicate planned attendance at specific scientific sessions and special sessions (including breakfast symposia and the PICA Risk Management program). About Your Information: All communication concerning the Annual Meeting originating from APMA or supplier vendors who purchase our meeting registrant data will be directed to the contact information below. AUGUST 16 - 19, 2012 • WASHINGTON, D.C. MARRIOTT WARDMAN PARK HOTEL n Your Information Last Name Formal First Name Nickname (or first name) for badge APMA Member Number Address City/State/Zip Code or Province/Country/Postal Code Daytime Telephone n Fax Number E-mail Address Your Guest’s Information (If you have additional guests, please attach a separate sheet.) Formal First Name Nickname (or first name) for badge Last Name n Additional Information q Check here if you have a disability and may require accommodations to participate fully. APMA will contact you. n Annual Meeting Registration & Fees (circle appropriate amounts) q APMA Member q APMA Life Member q Non-APMA Member q Health Professional: RN, PT, PA, MD, DO, CPed, Chiropodist, ATC Until April 27, 2012 $295.00 $95.00 $795.00 $795.00 Until July 29, 2012 $495.00 $295.00 $795.00 $795.00 After July 29, 2012 $595.00 $295.00 $795.00 $795.00 Please Note: n Educational topics are subject to change as the program schedule develops. n All registration fees must be paid in advance. n Payment must be received with your registration form. Registrations without complete payment will not be processed. n Registration for the APMA Annual Scientific Meeting includes educational sessions (unless otherwise noted), exhibit hall entry, and refreshment breaks. n A confirmation of registration will be sent to you by fax, mail, or e-mail. n Written requests for registration refunds must be postmarked on or before July 15, 2012. Registration fees are refunded less a $50 processing fee. All refunds will be issued after the meeting has occurred. n No refunds will be made after July 15, 2012. Refunds are not granted to no-shows. Complimentary Registration (check one) q DPM: Student q DPM: Resident/Fellow/Postgraduate APMA Member q Speaker q Other (Please explain; include name of authorizing organization and individual: __________________________________________________________) q APMA 100th Anniversary Gala featuring Frank Caliendo, Saturday, August 18, 8:00 pm - 11:00 pm Number of tickets (10 maximum): ____ $50 per person until July 29 Total: $__________ NOTE: After July 29, tickets are only available onsite at $75 per person. n Payment Registration Amount ———— Payment type (check one). Registration will not be processed unless accompanied by full payment. q Check enclosed (payable to APMA, Inc.) q Mastercard q Visa q American Express q Discover Credit Card Number (please print clearly) Name on Card (please print) Authorized Signature Day Phone of Cardholder Date Expiration Date Mail your completed registration form to: American Podiatric Medical Association Annual Meeting Office 9312 Old Georgetown Road Bethesda, MD 20814-1621 or fax to: 301-530-2752 WWW.APMA.ORG/THENATIONAL PDF-NEWS as of 12/8/2011 http://www.apma.org/thenational http://www.apma.org/thenational

Table of Contents for the Digital Edition of APMA News - February 2012

APMA News - February 2012
President’s Message
Contents
APMA Social Media: 2011 Success and 2012 Stategy
The National in 2012: Celebrating 100 Years Advancing Podiatric Medicine
APMA By the Decade: 1922–1931
Profiles in Progress: Student Recruitment
2011 Podiatric Practice Survey: Sources for Patient Referrals
Confronting the Residency Shortage
Reimbursement
Federal Advocacy Forum
APMAPAC Chair Report
IT Consultant
Website Wisdom
Technofile
Young Voices
Small Business 101
APMA All Stars
Awards Nominations
In Short
Worthy of Note
Resolutions Submissions
Affiliates Corner
List of Affiliated Organizations
Insurance Advisor
New Members
Death Notices
Annual Scientifi c Meeting Registration Form
Annual Scientific Meeting Sponsors
APMAPAC Update
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions

APMA News - February 2012