2011 Annual CME Conference Registration

Each paid conference registration includes breakfast each morning, all refreshment breaks, access to general sessions and the exhibit hall, a commemorative conference bag and admission to "A Night at the Museum with VAPA" at the Military Aviation Museum on Wednesday, July 27 from 5:30 – 8:30 PM.

* required field

Online Payments

First Name: (use proper capitalization for Name Badges)
*

Last Name:
*

Credentials: (as it will appear on Name Badge)

Are you a conference speaker?
Yes No

For Member registrations, please enter VAPA ID:
What's my ID?
Note: You will not be allowed to register as a member without your VAPA ID.

NCCPA ID: (required to log CME hours with NCCPA)

What is your specialty area?

Mailing Address

Address:
*

City:
*

State:
*

Zip:
*

Contact Information

Email:
*

Contact Phone:
*

Fax:

How did you learn about the conference?
If other, please describe:

Conference Registration and Information

	Early registration By 6/27/2011	Late registration After 6/27/2011	On-site registration
Member Registration	$390	$440	$465
Non-Member Registration	$440	$490	$520
Student Registration	$180	$180	$190
Spouse/Guest Registration	$255	$270	$285

Registration and Refund Policy
REFUNDS/SUBSTITUTIONS — Cancellations made in writing on or before July 11, 2011 are eligible for a full refund minus a $50 administration fee. NO REFUNDS will be granted after July 11, 2011.

Select Conference Registration:
*

Are you a First-time Conference Attendee? Yes No

Do you require Vegetarian or Gluten-Free Meals?

Social Activity Registration

I will be attending: (included in registration fee)
Night at the Military Aviation Museum

Join VAPA for exclusive after hours access to the Military Aviation Museum <http://www.militaryaviationmuseum.org> on Wednesday, July 27th from 5:30 – 8:30 PM. You and your family are invited to wander around the 60,000 square foot museum at your leisure and marvel at the many historic airplanes on display in the four hangars. Light hors d'oeuvres and refreshments will be provided in addition to a cash bar. Each paid conference registration includes one admission to the museum; however, there is a cost for additional family members to attend.

Additional 'Night at the Museum' Tickets
Number of additional Adult tickets, $20 each (age 13 and over)
Number of additional Child tickets, $15 each (ages 12 and under)
Number of additional Baby tickets, FREE (age 2 and under)

Would you like to purchase a Conference T-Shirt for $10? Please select quantity & notate sizes:

T-shirt Quantity:

Notate Sizes: (Sizes range from Sm. to XXL)
(if no sizes are notated, we will select Large)

Special Coupon Code: case-sensitive
If you were given a coupon code for your registration, please enter it above

Workshop Registration

All workshops are two hours in length and are an additional cost to attend. Please choose any additional workshops to attend below.

Workshops on Monday, July 25, 2011
	Information Mastery: Using "Medical Poetry" to Stay Up-to-Date and Help Save the Global Economy	July 25 / 1:00 pm	VAPA Member: $95.00 / Nonmember: $105.00
	Advanced Suturing	July 25 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	None

Workshops on Tuesday, July 26, 2011
	EKG Review	July 26 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	Medical Spanish Part I	July 26 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	Practical Management of Common Sleep Disorders	July 26 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	Splinting 101	July 26 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	None

Workshops on Wednesday, July 27, 2011
	Drug Interactions - A Review	July 27 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	Medical Spanish Part II (must select Part I as well)	July 27 / 3:00 pm	VAPA Member: $0.00 / Nonmember: $0.00
	The Pre-Operative Evaluation of a Patient	July 27 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	None

Workshops on Thursday, July 28, 2011
	Dermatology	July 28 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	Pulmonary Workshop - Asthma/COPD	July 28 / 3:00 pm	VAPA Member: $75.00 / Nonmember: $85.00
	None

Online Payments